Haptic feedback devices for surgical robot

ABSTRACT

A control system for a surgical robot is disclosed. The control system includes a controller, a sensor, a feedback device, a first socket, and a stand-alone input device. The handheld user interface may control a function of a robotic surgical system and is coupled to the sensor and the controller. The sensor is coupled to the controller. The feedback device is coupled to the controller and is configured to provide feedback associated with the robotic surgical system to a user. The controller is communicatively coupleable to the robotic surgical system and is configured to send robot control signals to the robotic surgical system, to receive feedback signals from the robotic surgical system, and to send feedback control signals to the feedback device to control the feedback provided to the user. The controller is configured to couple to a stand-alone input device through the first socket.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation application claiming priority under35 U.S.C. §120 to U.S. patent application Ser. No. 14/921,430, filedOct. 23, 2015, entitled “HAPTIC FEEDBACK DEVICES FOR SURGICAL ROBOT,”which claims priority to U.S. patent application Ser. No. 13/539,096,filed Jun. 29, 2012, entitled “HAPTIC FEEDBACK DEVICES FOR SURGICALROBOT,” now U.S. Pat. No. 9,198,714, the entire disclosure of which ishereby incorporated by reference herein.

This application is related to the following U.S. Patent Applications,filed Jun. 29, 2012, which are incorporated herein by reference in theirentirety:

U.S. patent application Ser. No. 13/539,110, entitled “Lockout Mechanismfor Use with Robotic Electrosurgical Device,” now U.S. Pat. No.9,326,788;

U.S. patent application Ser. No. 13/539,117, entitled “Closed FeedbackControl for Electrosurgical Device,” now U.S. Pat. No. 9,226,767;

U.S. patent application Ser. No. 13/538,588, entitled “SurgicalInstruments with Articulating Shafts,” now U.S. Pat. No. 9,393,037;

U.S. patent application Ser. No. 13/538,601, entitled “UltrasonicSurgical Instruments with Distally Positioned Transducers,” now U.S.Patent Application Publication No. 2014/0005702;

U.S. patent application Ser. No. 13/538,700, entitled “SurgicalInstruments with Articulating Shafts,” now U.S. Pat. No. 9,408,622;

U.S. patent application Ser. No. 13/538,711, entitled “UltrasonicSurgical Instruments with Distally Positioned Jaw Assemblies,” now U.S.Pat. No. 9,351,754;

U.S. patent application Ser. No. 13/538,720, entitled “SurgicalInstruments with Articulating Shafts,” now U.S. Patent ApplicationPublication No. 2014/0005705;

U.S. patent application Ser. No. 13/538,733, entitled “UltrasonicSurgical Instruments with Control Mechanisms,” now U.S. PatentApplication Publication No. 2014/0005681; and

U.S. patent application Ser. No. 13/539,122, entitled “SurgicalInstruments with Fluid Management System,” now U.S. Pat. No. 9,283,045.

BACKGROUND

The present disclosure relates generally to the field of roboticsurgery. In particular, the present disclosure relates to, although notexclusively, robotically controlled surgical instruments. Moreparticularly, the present disclosure relates to, although notexclusively, control systems having haptic feedback for controllingrobotic surgical systems.

Ultrasonic surgical devices, such as ultrasonic scalpels, are used inmany applications in surgical procedures by virtue of their uniqueperformance characteristics. Depending upon specific deviceconfigurations and operational parameters, ultrasonic surgical devicescan provide substantially simultaneous transection of tissue andhomeostasis by coagulation, desirably minimizing patient trauma. Anultrasonic surgical device comprises a proximally-positioned ultrasonictransducer and an instrument coupled to the ultrasonic transducer havinga distally-mounted end effector comprising an ultrasonic blade to cutand seal tissue. The end effector is typically coupled either to ahandle and/or a robotic surgical implement via a shaft. The blade isacoustically coupled to the transducer via a waveguide extending throughthe shaft. Ultrasonic surgical devices of this nature can be configuredfor open surgical use, laparoscopic, or endoscopic surgical proceduresincluding robotic-assisted procedures.

Ultrasonic energy cuts and coagulates tissue using temperatures lowerthan those used in electrosurgical procedures. Vibrating at highfrequencies (e.g., 55,500 times per second), the ultrasonic bladedenatures protein in the tissue to form a sticky coagulum. Pressureexerted on tissue by the blade surface collapses blood vessels andallows the coagulum to form a haemostatic seal. A surgeon can controlthe cutting speed and coagulation by the force applied to the tissue bythe end effector, the time over which the force is applied and theselected excursion level of the end effector.

Also used in many surgical applications are electrosurgical devices.Electrosurgical devices apply electrical energy to tissue in order totreat tissue. An electrosurgical device may comprise an instrumenthaving a distally-mounted end effector comprising one or moreelectrodes. The end effector can be positioned against tissue such thatelectrical current is introduced into the tissue. Electrosurgicaldevices can be configured for bipolar or monopolar operation. Duringbipolar operation, current is introduced into and returned from thetissue by active and return electrodes, respectively, of the endeffector. During monopolar operation, current is introduced into thetissue by an active electrode of the end effector and returned through areturn electrode (e.g., a grounding pad) separately located on apatient's body. Heat generated by the current flow through the tissuemay form hemostatic seals within the tissue and/or between tissues andthus may be particularly useful for sealing blood vessels, for example.The end effector of an electrosurgical device sometimes also comprises acutting member that is movable relative to the tissue and the electrodesto transect the tissue.

Electrical energy applied by an electrosurgical device can betransmitted to the instrument by a generator. The electrical energy maybe in the form of radio frequency (“RF”) energy. RF energy is a form ofelectrical energy that may be in the frequency range of 300 kHz to 1MHz. During its operation, an electrosurgical device can transmit lowfrequency RF energy through tissue, which causes ionic agitation, orfriction, in effect resistive heating, thereby increasing thetemperature of the tissue. Because a sharp boundary may be createdbetween the affected tissue and the surrounding tissue, surgeons canoperate with a high level of precision and control, without sacrificingun-targeted adjacent tissue. The low operating temperatures of RF energymay be useful for removing, shrinking, or sculpting soft tissue whilesimultaneously sealing blood vessels. RF energy may work particularlywell on connective tissue, which is primarily comprised of collagen andshrinks when contacted by heat.

Current robotic surgical systems utilize specialized control systemsdesigned specifically for each machine. The specialized control systemsrequire a surgeon to train and become proficient on the specializedcontrol system prior to use of a robotic surgical system in actualsurgery. In addition to long training times, use of specialized controlsystems may result in a surgeon loosing proficiency with non-roboticsurgical systems and techniques. Therefore, it would be desirable tohave a control system for robotic surgical systems usable by themajority of surgeons with minimal training. It would also be desirableto have a control system which simulated the use of non-robotic surgicalinstruments.

SUMMARY

A control system for a surgical robot is disclosed. The control systemincludes a controller, a sensor, a feedback device, a first socket, anda stand-alone input device. The handheld user interface may control afunction of a robotic surgical system and is coupled to the sensor andthe controller. The sensor is coupled to the controller. The feedbackdevice is coupled to the controller and is configured to providefeedback associated with the robotic surgical system to a user. Thecontroller is communicatively coupleable to the robotic surgical systemand is configured to send robot control signals to the robotic surgicalsystem, to receive feedback signals from the robotic surgical system,and to send feedback control signals to the feedback device to controlthe feedback provided to the user. The controller is configured tocouple to a stand-alone input device through the first socket.

BRIEF DESCRIPTION OF THE FIGURES

The features of the various embodiments are set forth with particularityin the appended claims. The various embodiments, however, both as toorganization and methods of operation, together with advantages thereof,may best be understood by reference to the following description, takenin conjunction with the accompanying drawings as follows:

FIG. 1 illustrates one embodiment of a surgical system including asurgical instrument and an ultrasonic generator.

FIG. 2 illustrates one embodiment of the surgical instrument shown inFIG. 1.

FIG. 3 illustrates one embodiment of an ultrasonic end effector.

FIG. 4 illustrates another embodiment of an ultrasonic end effector.

FIG. 5 illustrates an exploded view of one embodiment of the surgicalinstrument shown in FIG. 1.

FIG. 6 illustrates a cut-away view of one embodiment of the surgicalinstrument shown in FIG. 1.

FIG. 7 illustrates various internal components of one example embodimentof the surgical instrument shown in FIG. 1

FIG. 8 illustrates a top view of one embodiment of a surgical systemincluding a surgical instrument and an ultrasonic generator.

FIG. 9 illustrates one embodiment of a rotation assembly included in oneexample embodiment of the surgical instrument of FIG. 1.

FIG. 10 illustrates one embodiment of a surgical system including asurgical instrument having a single element end effector.

FIG. 11 is a perspective view of one embodiment of an electrical energysurgical instrument.

FIG. 12 is a side view of a handle of one embodiment of the surgicalinstrument of FIG. 11 with a half of a handle body removed to illustratesome of the components therein.

FIG. 13 illustrates a perspective view of one embodiment of the endeffector of the surgical instrument of FIG. 11 with the jaws open andthe distal end of an axially movable member in a retracted position.

FIG. 14 illustrates a perspective view of one embodiment of the endeffector of the surgical instrument of FIG. 11 with the jaws closed andthe distal end of an axially movable member in a partially advancedposition.

FIG. 15 illustrates a perspective view of one embodiment of the axiallymoveable member of the surgical instrument of FIG. 11.

FIG. 16 illustrates a section view of one embodiment of the end effectorof the surgical instrument of FIG. 11.

FIG. 17 illustrates a section a perspective view of one embodiment of acordless electrical energy surgical instrument.

FIG. 18A illustrates a side view of a handle of one embodiment of thesurgical instrument of FIG. 17 with a half handle body removed toillustrate various components therein.

FIG. 18B illustrates an RF drive and control circuit, according to oneembodiment.

FIG. 18C illustrates the main components of the controller, according toone embodiment.

FIG. 19 illustrates a block diagram of one embodiment of a roboticsurgical system.

FIG. 20 illustrates one embodiment of a robotic arm cart.

FIG. 21 illustrates one embodiment of the robotic manipulator of therobotic arm cart of FIG. 20.

FIG. 22 illustrates one embodiment of a robotic arm cart having analternative set-up joint structure.

FIG. 23 illustrates one embodiment of a controller that may be used inconjunction with a robotic arm cart, such as the robotic arm carts ofFIGS. 19-22.

FIG. 24 illustrates one embodiment of an ultrasonic surgical instrumentadapted for use with a robotic system.

FIG. 25 illustrates one embodiment of an electrosurgical instrumentadapted for use with a robotic system.

FIG. 26 illustrates one embodiment of an instrument drive assembly thatmay be coupled to a surgical manipulator to receive and control thesurgical instrument shown in FIG. 24.

FIG. 27 illustrates another view of the instrument drive assemblyembodiment of FIG. 26 including the surgical instrument of FIG. 24.

FIG. 28 illustrates another view of the instrument drive assemblyembodiment of FIG. 26 including the electrosurgical instrument of FIG.25.

FIGS. 29-31 illustrate additional views of the adapter portion of theinstrument drive assembly embodiment of FIG. 26.

FIGS. 32-34 illustrate one embodiment of the instrument mounting portionof FIGS. 24-25 showing components for translating motion of the drivenelements into motion of the surgical instrument.

FIGS. 35-37 illustrate an alternate embodiment of the instrumentmounting portion of FIGS. 24-25 showing an alternate example mechanismfor translating rotation of the driven elements into rotational motionabout the axis of the shaft and an alternate example mechanism forgenerating reciprocating translation of one or more members along theaxis of the shaft 538.

FIGS. 38-42 illustrate an alternate embodiment of the instrumentmounting portion FIGS. 24-25 showing another alternate example mechanismfor translating rotation of the driven elements into rotational motionabout the axis of the shaft.

FIGS. 43-46A illustrate an alternate embodiment of the instrumentmounting portion showing an alternate example mechanism for differentialtranslation of members along the axis of the shaft (e.g., forarticulation).

FIGS. 46B-46C illustrate one embodiment of a tool mounting portioncomprising internal power and energy sources.

FIG. 47 illustrates one embodiment of a robotic surgical control systemin block form.

FIGS. 48-50 illustrate one embodiment of a robotic surgical controlsystem with simplified components.

FIGS. 51-52 illustrate one embodiment of a robotic surgical controlsystem comprising a lever and a one-degree of movement socket.

FIG. 53 illustrates one embodiment of a robotic surgical control systemcomprising a lever and a two-degrees of movement socket.

FIG. 54 illustrates one embodiment of a robotic surgical control systemcomprising a lever and an unrestricted two-degrees of movement socket.

FIGS. 55-56 illustrate one embodiment of a robotic surgical controlsystem comprising a lever and a four-degrees of movement socket.

FIG. 57 illustrates one embodiment of a stand-alone input device for usewith a robotic surgical control system.

FIGS. 58-60 illustrate one embodiment of a haptic feedback deviceutilizing a temperature gradient to provide tactile feedback.

FIG. 61 illustrates one embodiment of a robotic surgical control systemcomprising a surgical device handle and a six-degrees of movementsocket.

FIG. 62 illustrates one embodiment of a robotic surgical control systemcomprising a surgical device handle and a three-degrees of movementsocket.

FIG. 63 illustrates a robotic surgical control system comprisingmultiple feedback devices.

FIGS. 64-65 illustrate possible embodiments of the relationship betweena surgical device handle and a surgical instrument.

FIG. 66 illustrates one embodiment of a cordless robotic surgicalcontrol system.

FIG. 67 illustrates one embodiment of a robotic surgical control systemintegrated with a standard robotic controller.

FIG. 68 illustrates one embodiment of a system for generating a feedbacksignal for a robotic surgical control system.

DESCRIPTION

Various example embodiments are directed to a control system for arobotic surgical system. The robotic surgical control system maycomprise a housing. A controller is located within the housing and iscoupled to a socket. The socket receives a handheld surgical userinterface therein to control a surgical instrument. The surgicalinstrument is connected to the surgical robot and comprises an endeffector and a mechanical interface to manipulate the end effector. Themechanical interface is coupled to the controller. At least one sensoris coupled to the controller and the socket to convert movement of thehandheld surgical user interface into electrical signals correspondingto the movement of the surgical instrument. At least one feedback deviceis coupled to the controller to provide feedback to a user. The feedbackis associated with a predetermined function of the surgical instrument.

Some example embodiments are directed towards robotic surgical controlsystems having a handheld surgical user interface comprising a lever.The lever may be translatably moveable in a distal/proximal direction,an up/down direction, and/or a left/right direction. The lever may alsobe rotatably moveable about a pivot point in any of proximal/distal,up/down, or left/right planes. In some example embodiments, the levermay comprise one or more additional inputs, such as, for example, atrigger, a switch, a resistive sleeve, or any other suitable input.

Other example embodiments are directed towards robotic surgical controlsystems including a handheld surgical user interface comprising asurgical device handle. The surgical device handle may be configured tosimulate the feel and operation of non-robotic surgical instruments,such as, for example, non-robotic endoscopic instruments. The surgicaldevice handle may be translatably moveable in a distal/proximaldirection, an up/down direction, and/or a left/right direction. Thesurgical device handle may also be rotatably moveable about a pivotpoint in any of proximal/distal, up/down, or left/right planes. In someembodiments, the surgical device handle may include one or moreadditional inputs, such as, for example, a trigger, a switch, one ormore rotational knobs, or any other suitable input.

In additional example embodiments, the robotic surgical control systemincludes one or more feedback devices. In some embodiments, the one ormore feedback devices may be located in the housing. In otherembodiments, the one or more feedback devices may be located in or onthe handheld surgical user interface. The one or more feedback devicesmay provide any suitable form of sensory feedback, such as, for example,auditory feedback (sound), haptic or tactile feedback (touch), opticalfeedback (visual), olfactory feedback (smell), gustatory feedback(taste), and/or equilibrioception (balance feedback). Haptic feedbackmay be provided through various forms, for example, mechanosensation,including, but not limited to, vibrosensation (vibrations) andpressure-sensation, thermoperception (heat), and/or cryoperception(cold).

Reference will now be made in detail to several embodiments, includingembodiments showing example implementations of manual and roboticsurgical instruments with end effectors comprising ultrasonic and/orelectrosurgical elements. Wherever practicable similar or like referencenumbers may be used in the figures and may indicate similar or likefunctionality. The figures depict example embodiments of the disclosedsurgical instruments and/or methods of use for purposes of illustrationonly. One skilled in the art will readily recognize from the followingdescription that alternative example embodiments of the structures andmethods illustrated herein may be employed without departing from theprinciples described herein.

FIG. 1 is a right side view of one embodiment of an ultrasonic surgicalinstrument 10. In the illustrated embodiment, the ultrasonic surgicalinstrument 10 may be employed in various surgical procedures includingendoscopic or traditional open surgical procedures. In one exampleembodiment, the ultrasonic surgical instrument 10 comprises a handleassembly 12, an elongated shaft assembly 14, and an ultrasonictransducer 16. The handle assembly 12 comprises a trigger assembly 24, adistal rotation assembly 13, and a switch assembly 28. The elongatedshaft assembly 14 comprises an end effector assembly 26, which compriseselements to dissect tissue or mutually grasp, cut, and coagulate vesselsand/or tissue, and actuating elements to actuate the end effectorassembly 26. The handle assembly 12 is adapted to receive the ultrasonictransducer 16 at the proximal end. The ultrasonic transducer 16 ismechanically engaged to the elongated shaft assembly 14 and portions ofthe end effector assembly 26. The ultrasonic transducer 16 iselectrically coupled to a generator 20 via a cable 22. Although themajority of the drawings depict a multiple end effector assembly 26 foruse in connection with laparoscopic surgical procedures, the ultrasonicsurgical instrument 10 may be employed in more traditional open surgicalprocedures and in other embodiments, and may be configured for use inendoscopic procedures. For the purposes herein, the ultrasonic surgicalinstrument 10 is described in terms of an endoscopic instrument;however, it is contemplated that an open and/or laparoscopic version ofthe ultrasonic surgical instrument 10 also may include the same orsimilar operating components and features as described herein.

In various embodiments, the generator 20 comprises several functionalelements, such as modules and/or blocks. Different functional elementsor modules may be configured for driving different kinds of surgicaldevices. For example, an ultrasonic generator module 21 may drive anultrasonic device, such as the ultrasonic surgical instrument 10. Insome example embodiments, the generator 20 also comprises anelectrosurgery/RF generator module 23 for driving an electrosurgicaldevice (or an electrosurgical embodiment of the ultrasonic surgicalinstrument 10). In various embodiments, the generator 20 may be formedintegrally within the handle assembly 12. In such implementations, abattery would be co-located within the handle assembly 12 to act as theenergy source. FIG. 18A and accompanying disclosures provide one exampleof such implementations. As shown in FIG. 1, according to variousembodiments, the ultrasonic generator module 21 and/or theelectrosurgery/RF generator module 23 may be located external to thegenerator (shown in phantom as ultrasonic generator module 21′ andelectrosurgery/RF generator module 23′).

In some embodiments, the electrosurgery/RF generator module 23 may beconfigured to generate a therapeutic and/or a sub-therapeutic energylevel. In the example embodiment illustrated in FIG. 1, the generator 20includes a control system 25 integral with the generator 20 and a footswitch 29 connected to the generator via a cable 27. The generator 20may also comprise a triggering mechanism for activating a surgicalinstrument, such as the instrument 10. The triggering mechanism mayinclude a power switch (not shown) as well as a foot switch 29. Whenactivated by the foot switch 29, the generator 20 may provide energy todrive the acoustic assembly of the surgical instrument 10 and to drivethe end effector 18 at a predetermined excursion level. The generator 20drives or excites the acoustic assembly at any suitable resonantfrequency of the acoustic assembly and/or derives thetherapeutic/sub-therapeutic electromagnetic/RF energy.

In one embodiment, the electrosurgical/RF generator module 23 may beimplemented as an electrosurgery unit (ESU) capable of supplying powersufficient to perform bipolar electrosurgery using radio frequency (RF)energy. In one embodiment, the ESU can be a bipolar ERBE ICC 350 sold byERBE USA, Inc. of Marietta, Ga. In bipolar electrosurgery applications,as previously discussed, a surgical instrument having an activeelectrode and a return electrode can be utilized, wherein the activeelectrode and the return electrode can be positioned against, oradjacent to, the tissue to be treated such that current can flow fromthe active electrode to the return electrode through the tissue.Accordingly, the electrosurgical/RF module 23 generator may beconfigured for therapeutic purposes by applying electrical energy to thetissue T sufficient for treating the tissue (e.g., cauterization).

In one embodiment, the electrosurgical/RF generator module 23 may beconfigured to deliver a sub-therapeutic RF signal to implement a tissueimpedance measurement module. In one embodiment, the electrosurgical/RFgenerator module 23 comprises a bipolar radio frequency generator asdescribed in more detail below. In one embodiment, theelectrosurgical/RF generator module 23 may be configured to monitorelectrical impedance Z, of tissue T and to control the characteristicsof time and power level based on the tissue T by way of a returnelectrode on provided on a clamp member of the end effector assembly 26.Accordingly, the electrosurgical/RF generator module 23 may beconfigured for sub-therapeutic purposes for measuring the impedance orother electrical characteristics of the tissue T. Techniques and circuitconfigurations for measuring the impedance or other electricalcharacteristics of tissue T are discussed in more detail in commonlyassigned U.S. Patent Publication No. 2011/0015631, titled“Electrosurgical Generator for Ultrasonic Surgical Instruments,” thedisclosure of which is herein incorporated by reference in its entirety.

A suitable ultrasonic generator module 21 may be configured tofunctionally operate in a manner similar to the GEN300 sold by EthiconEndo-Surgery, Inc. of Cincinnati, Ohio as is disclosed in one or more ofthe following U.S. patents, all of which are incorporated by referenceherein: U.S. Pat. No. 6,480,796 (Method for Improving the Start Up of anUltrasonic System Under Zero Load Conditions); U.S. Pat. No. 6,537,291(Method for Detecting Blade Breakage Using Rate and/or ImpedanceInformation); U.S. Pat. No. 6,662,127 (Method for Detecting Presence ofa Blade in an Ultrasonic System); U.S. Pat. No. 6,679,899 (Method forDetecting Transverse Vibrations in an Ultrasonic Hand Piece); U.S. Pat.No. 6,977,495 (Detection Circuitry for Surgical Handpiece System); U.S.Pat. No. 7,077,853 (Method for Calculating Transducer Capacitance toDetermine Transducer Temperature); U.S. Pat. No. 7,179,271 (Method forDriving an Ultrasonic System to Improve Acquisition of Blade ResonanceFrequency at Startup); and U.S. Pat. No. 7,273,483 (Apparatus and Methodfor Alerting Generator Function in an Ultrasonic Surgical System).

It will be appreciated that in various embodiments, the generator 20 maybe configured to operate in several modes. In one mode, the generator 20may be configured such that the ultrasonic generator module 21 and theelectrosurgical/RF generator module 23 may be operated independently.

For example, the ultrasonic generator module 21 may be activated toapply ultrasonic energy to the end effector assembly 26 andsubsequently, either therapeutic or sub-therapeutic RF energy may beapplied to the end effector assembly 26 by the electrosurgical/RFgenerator module 23. As previously discussed, the subtherapeuticelectrosurgical/RF energy may be applied to tissue clamped between claimelements of the end effector assembly 26 to measure tissue impedance tocontrol the activation, or modify the activation, of the ultrasonicgenerator module 21. Tissue impedance feedback from the application ofthe subtherapeutic energy also may be employed to activate a therapeuticlevel of the electrosurgical/RF generator module 23 to seal the tissue(e.g., vessel) clamped between claim elements of the end effectorassembly 26.

In another embodiment, the ultrasonic generator module 21 and theelectrosurgical/RF generator module 23 may be activated simultaneously.In one example, the ultrasonic generator module 21 is simultaneouslyactivated with a sub-therapeutic RF energy level to measure tissueimpedance simultaneously while the ultrasonic blade of the end effectorassembly 26 cuts and coagulates the tissue (or vessel) clamped betweenthe clamp elements of the end effector assembly 26. Such feedback may beemployed, for example, to modify the drive output of the ultrasonicgenerator module 21. In another example, the ultrasonic generator module21 may be driven simultaneously with electrosurgical/RF generator module23 such that the ultrasonic blade portion of the end effector assembly26 is employed for cutting the damaged tissue while theelectrosurgical/RF energy is applied to electrode portions of the endeffector clamp assembly 26 for sealing the tissue (or vessel).

When the generator 20 is activated via the triggering mechanism, in oneembodiment electrical energy is continuously applied by the generator 20to a transducer stack or assembly of the acoustic assembly. In anotherembodiment, electrical energy is intermittently applied (e.g., pulsed)by the generator 20. A phase-locked loop in the control system of thegenerator 20 may monitor feedback from the acoustic assembly. The phaselock loop adjusts the frequency of the electrical energy sent by thegenerator 20 to match the resonant frequency of the selectedlongitudinal mode of vibration of the acoustic assembly. In addition, asecond feedback loop in the control system 25 maintains the electricalcurrent supplied to the acoustic assembly at a pre-selected constantlevel in order to achieve substantially constant excursion at the endeffector 18 of the acoustic assembly. In yet another embodiment, a thirdfeedback loop in the control system 25 monitors impedance betweenelectrodes located in the end effector assembly 26. Although FIGS. 1-9show a manually operated ultrasonic surgical instrument, it will beappreciated that ultrasonic surgical instruments may also be used inrobotic applications, for example, as described herein, as well ascombinations of manual and robotic applications.

In ultrasonic operation mode, the electrical signal supplied to theacoustic assembly may cause the distal end of the end effector 18, tovibrate longitudinally in the range of, for example, approximately 20kHz to 250 kHz. According to various embodiments, the blade 22 mayvibrate in the range of about 54 kHz to 56 kHz, for example, at about55.5 kHz. In other embodiments, the blade 22 may vibrate at otherfrequencies including, for example, about 31 kHz or about 80 kHz. Theexcursion of the vibrations at the blade can be controlled by, forexample, controlling the amplitude of the electrical signal applied tothe transducer assembly of the acoustic assembly by the generator 20. Asnoted above, the triggering mechanism of the generator 20 allows a userto activate the generator 20 so that electrical energy may becontinuously or intermittently supplied to the acoustic assembly. Thegenerator 20 also has a power line for insertion in an electro-surgicalunit or conventional electrical outlet. It is contemplated that thegenerator 20 can also be powered by a direct current (DC) source, suchas a battery. The generator 20 can comprise any suitable generator, suchas Model No. GEN04, and/or Model No. GEN11 available from EthiconEndo-Surgery, Inc.

FIG. 2 is a left perspective view of one example embodiment of theultrasonic surgical instrument 10 showing the handle assembly 12, thedistal rotation assembly 13, the elongated shaft assembly 14, and theend effector assembly 26. In the illustrated embodiment the elongatedshaft assembly 14 comprises a distal end 52 dimensioned to mechanicallyengage the end effector assembly 26 and a proximal end 50 thatmechanically engages the handle assembly 12 and the distal rotationassembly 13. The proximal end 50 of the elongated shaft assembly 14 isreceived within the handle assembly 12 and the distal rotation assembly13. More details relating to the connections between the elongatedendoscopic shaft assembly 14, the handle assembly 12, and the distalrotation assembly 13 are provided in the description of FIGS. 5 and 7.

In the illustrated embodiment, the trigger assembly 24 comprises atrigger 32 that operates in conjunction with a fixed handle 34. Thefixed handle 34 and the trigger 32 are ergonomically formed and adaptedto interface comfortably with the user. The fixed handle 34 isintegrally associated with the handle assembly 12. The trigger 32 ispivotally movable relative to the fixed handle 34 as explained in moredetail below with respect to the operation of the ultrasonic surgicalinstrument 10. The trigger 32 is pivotally movable in direction 33Atoward the fixed handle 34 when the user applies a squeezing forceagainst the trigger 32. A spring element 98 (FIG. 5) causes the trigger32 to pivotally move in direction 33B when the user releases thesqueezing force against the trigger 32.

In one example embodiment, the trigger 32 comprises an elongated triggerhook 36, which defines an aperture 38 between the elongated trigger hook36 and the trigger 32. The aperture 38 is suitably sized to receive oneor multiple fingers of the user therethrough. The trigger 32 also maycomprise a resilient portion 32 a molded over the trigger 32 substrate.The resilient portion 32 a is formed to provide a more comfortablecontact surface for control of the trigger 32 in outward direction 33B.In one example embodiment, the resilient portion 32 a may also beprovided over a portion of the elongated trigger hook 36 as shown, forexample, in FIG. 2. The proximal surface of the elongated trigger hook32 remains uncoated or coated with a non-resilient substrate to enablethe user to easily slide their fingers in and out of the aperture 38. Inanother embodiment, the geometry of the trigger forms a fully closedloop which defines an aperture suitably sized to receive one or multiplefingers of the user therethrough. The fully closed loop trigger also maycomprise a resilient portion molded over the trigger substrate.

In one example embodiment, the fixed handle 34 comprises a proximalcontact surface 40 and a grip anchor or saddle surface 42. The saddlesurface 42 rests on the web where the thumb and the index finger arejoined on the hand. The proximal contact surface 40 has a pistol gripcontour that receives the palm of the hand in a normal pistol grip withno rings or apertures. The profile curve of the proximal contact surface40 may be contoured to accommodate or receive the palm of the hand. Astabilization tail 44 is located towards a more proximal portion of thehandle assembly 12. The stabilization tail 44 may be in contact with theuppermost web portion of the hand located between the thumb and theindex finger to stabilize the handle assembly 12 and make the handleassembly 12 more controllable.

In one example embodiment, the switch assembly 28 may comprise a toggleswitch 30. The toggle switch 30 may be implemented as a single componentwith a central pivot 304 located within inside the handle assembly 12 toeliminate the possibility of simultaneous activation. In one exampleembodiment, the toggle switch 30 comprises a first projecting knob 30 aand a second projecting knob 30 b to set the power setting of theultrasonic transducer 16 between a minimum power level (e.g., MIN) and amaximum power level (e.g., MAX). In another embodiment, the rockerswitch may pivot between a standard setting and a special setting. Thespecial setting may allow one or more special programs to be implementedby the device. The toggle switch 30 rotates about the central pivot asthe first projecting knob 30 a and the second projecting knob 30 b areactuated. The one or more projecting knobs 30 a, 30 b are coupled to oneor more arms that move through a small arc and cause electrical contactsto close or open an electric circuit to electrically energize orde-energize the ultrasonic transducer 16 in accordance with theactivation of the first or second projecting knobs 30 a, 30 b. Thetoggle switch 30 is coupled to the generator 20 to control theactivation of the ultrasonic transducer 16. The toggle switch 30comprises one or more electrical power setting switches to activate theultrasonic transducer 16 to set one or more power settings for theultrasonic transducer 16. The forces required to activate the toggleswitch 30 are directed substantially toward the saddle point 42, thusavoiding any tendency of the instrument to rotate in the hand when thetoggle switch 30 is activated.

In one example embodiment, the first and second projecting knobs 30 a,30 b are located on the distal end of the handle assembly 12 such thatthey can be easily accessible by the user to activate the power withminimal, or substantially no, repositioning of the hand grip, making itsuitable to maintain control and keep attention focused on the surgicalsite (e.g., a monitor in a laparoscopic procedure) while activating thetoggle switch 30. The projecting knobs 30 a, 30 b may be configured towrap around the side of the handle assembly 12 to some extent to be moreeasily accessible by variable finger lengths and to allow greaterfreedom of access to activation in awkward positions or for shorterfingers.

In the illustrated embodiment, the first projecting knob 30 a comprisesa plurality of tactile elements 30 c, e.g., textured projections or“bumps” in the illustrated embodiment, to allow the user todifferentiate the first projecting knob 30 a from the second projectingknob 30 b. It will be appreciated by those skilled in the art thatseveral ergonomic features may be incorporated into the handle assembly12. Such ergonomic features are described in U.S. Pat. App. Pub. No.2009/0105750 entitled “Ergonomic Surgical Instruments”, now U.S. Pat.No. 8,623,027, which is incorporated by reference herein in itsentirety.

In one example embodiment, the toggle switch 30 may be operated by thehand of the user. The user may easily access the first and secondprojecting knobs 30 a, 30 b at any point while also avoiding inadvertentor unintentional activation at any time. The toggle switch 30 mayreadily operated with a finger to control the power to the ultrasonicassembly 16 and/or to the ultrasonic assembly 16. For example, the indexfinger may be employed to activate the first contact portion 30 a toturn on the ultrasonic assembly 16 to a maximum (MAX) power level. Theindex finger may be employed to activate the second contact portion 30 bto turn on the ultrasonic assembly 16 to a minimum (MIN) power level. Inanother embodiment, the rocker switch may pivot the instrument 10between a standard setting and a special setting. The special settingmay allow one or more special programs to be implemented by theinstrument 10. The toggle switch 30 may be operated without the userhaving to look at the first or second projecting knob 30 a, 30 b. Forexample, the first projecting knob 30 a or the second projecting knob 30b may comprise a texture or projections to tactilely differentiatebetween the first and second projecting knobs 30 a, 30 b withoutlooking.

In other embodiments, the trigger 32 and/or the toggle switch 30 may beemployed to actuate the electrosurgical/RF generator module 23individually or in combination with activation of the ultrasonicgenerator module 21.

In one example embodiment, the distal rotation assembly 13 is rotatablewithout limitation in either direction about a longitudinal axis “T.”The distal rotation assembly 13 is mechanically engaged to the elongatedshaft assembly 14. The distal rotation assembly 13 is located on adistal end of the handle assembly 12. The distal rotation assembly 13comprises a cylindrical hub 46 and a rotation knob 48 formed over thehub 46. The hub 46 mechanically engages the elongated shaft assembly 14.The rotation knob 48 may comprise fluted polymeric features and may beengaged by a finger (e.g., an index finger) to rotate the elongatedshaft assembly 14. The hub 46 may comprise a material molded over theprimary structure to form the rotation knob 48. The rotation knob 48 maybe overmolded over the hub 46. The hub 46 comprises an end cap portion46 a that is exposed at the distal end. The end cap portion 46 a of thehub 46 may contact the surface of a trocar during laparoscopicprocedures. The hub 46 may be formed of a hard durable plastic such aspolycarbonate to alleviate any friction that may occur between the endcap portion 46 a and the trocar. The rotation knob 48 may comprise“scallops” or flutes formed of raised ribs 48 a and concave portions 48b located between the ribs 48 a to provide a more precise rotationalgrip. In one example embodiment, the rotation knob 48 may comprise aplurality of flutes (e.g., three or more flutes). In other embodiments,any suitable number of flutes may be employed. The rotation knob 48 maybe formed of a softer polymeric material overmolded onto the hardplastic material. For example, the rotation knob 48 may be formed ofpliable, resilient, flexible polymeric materials including Versaflex®TPE alloys made by GLS Corporation, for example. This softer overmoldedmaterial may provide a greater grip and more precise control of themovement of the rotation knob 48. It will be appreciated that anymaterials that provide adequate resistance to sterilization, arebiocompatible, and provide adequate frictional resistance to surgicalgloves may be employed to form the rotation knob 48.

In one example embodiment, the handle assembly 12 is formed from two (2)housing portions or shrouds comprising a first portion 12 a and a secondportion 12 b. From the perspective of a user viewing the handle assembly12 from the distal end towards the proximal end, the first portion 12 ais considered the right portion and the second portion 12 b isconsidered the left portion. Each of the first and second portions 12 a,12 b includes a plurality of interfaces 69 (FIG. 7) dimensioned tomechanically align and engage each another to form the handle assembly12 and enclosing the internal working components thereof. The fixedhandle 34, which is integrally associated with the handle assembly 12,takes shape upon the assembly of the first and second portions 12 a and12 b of the handle assembly 12. A plurality of additional interfaces(not shown) may be disposed at various points around the periphery ofthe first and second portions 12 a and 12 b of the handle assembly 12for ultrasonic welding purposes, e.g., energy direction/deflectionpoints. The first and second portions 12 a and 12 b (as well as theother components described below) may be assembled together in anyfashion known in the art. For example, alignment pins, snap-likeinterfaces, tongue and groove interfaces, locking tabs, adhesive ports,may all be utilized either alone or in combination for assemblypurposes.

In one example embodiment, the elongated shaft assembly 14 comprises aproximal end 50 adapted to mechanically engage the handle assembly 12and the distal rotation assembly 13; and a distal end 52 adapted tomechanically engage the end effector assembly 26. The elongated shaftassembly 14 comprises an outer tubular sheath 56 and a reciprocatingtubular actuating member 58 located within the outer tubular sheath 56.The proximal end of the tubular reciprocating tubular actuating member58 is mechanically engaged to the trigger 32 of the handle assembly 12to move in either direction 60A or 60B in response to the actuationand/or release of the trigger 32. The pivotably moveable trigger 32 maygenerate reciprocating motion along the longitudinal axis “T.” Suchmotion may be used, for example, to actuate the jaws or clampingmechanism of the end effector assembly 26. A series of linkagestranslate the pivotal rotation of the trigger 32 to axial movement of ayoke coupled to an actuation mechanism, which controls the opening andclosing of the jaws of the clamping mechanism of the end effectorassembly 26. The distal end of the tubular reciprocating tubularactuating member 58 is mechanically engaged to the end effector assembly26. In the illustrated embodiment, the distal end of the tubularreciprocating tubular actuating member 58 is mechanically engaged to aclamp arm assembly 64, which is pivotable about a pivot point 70, toopen and close the clamp arm assembly 64 in response to the actuationand/or release of the trigger 32. For example, in the illustratedembodiment, the clamp arm assembly 64 is movable in direction 62A froman open position to a closed position about a pivot point 70 when thetrigger 32 is squeezed in direction 33A. The clamp arm assembly 64 ismovable in direction 62B from a closed position to an open positionabout the pivot point 70 when the trigger 32 is released or outwardlycontacted in direction 33B.

In one example embodiment, the end effector assembly 26 is attached atthe distal end 52 of the elongated shaft assembly 14 and includes aclamp arm assembly 64 and a blade 66. The jaws of the clamping mechanismof the end effector assembly 26 are formed by clamp arm assembly 64 andthe blade 66. The blade 66 is ultrasonically actuatable and isacoustically coupled to the ultrasonic transducer 16. The trigger 32 onthe handle assembly 12 is ultimately connected to a drive assembly,which together, mechanically cooperate to effect movement of the clamparm assembly 64. Squeezing the trigger 32 in direction 33A moves theclamp arm assembly 64 in direction 62A from an open position, whereinthe clamp arm assembly 64 and the blade 66 are disposed in a spacedrelation relative to one another, to a clamped or closed position,wherein the clamp arm assembly 64 and the blade 66 cooperate to grasptissue therebetween. The clamp arm assembly 64 may comprise a clamp pad(not shown) to engage tissue between the blade 66 and the clamp arm 64.Releasing the trigger 32 in direction 33B moves the clamp arm assembly64 in direction 62B from a closed relationship, to an open position,wherein the clamp arm assembly 64 and the blade 66 are disposed in aspaced relation relative to one another.

The proximal portion of the handle assembly 12 comprises a proximalopening 68 to receive the distal end of the ultrasonic assembly 16. Theultrasonic assembly 16 is inserted in the proximal opening 68 and ismechanically engaged to the elongated shaft assembly 14.

In one example embodiment, the elongated trigger hook 36 portion of thetrigger 32 provides a longer trigger lever with a shorter span androtation travel. The longer lever of the elongated trigger hook 36allows the user to employ multiple fingers within the aperture 38 tooperate the elongated trigger hook 36 and cause the trigger 32 to pivotin direction 33B to open the jaws of the end effector assembly 26. Forexample, the user may insert three fingers (e.g., the middle, ring, andlittle fingers) in the aperture 38. Multiple fingers allows the surgeonto exert higher input forces on the trigger 32 and the elongated triggerhook 36 to activate the end effector assembly 26. The shorter span androtation travel creates a more comfortable grip when closing orsqueezing the trigger 32 in direction 33A or when opening the trigger 32in the outward opening motion in direction 33B lessening the need toextend the fingers further outward. This substantially lessens handfatigue and strain associated with the outward opening motion of thetrigger 32 in direction 33B. The outward opening motion of the triggermay be spring-assisted by spring element 98 (FIG. 5) to help alleviatefatigue. The opening spring force is sufficient to assist the ease ofopening, but not strong enough to adversely impact the tactile feedbackof tissue tension during spreading dissection.

For example, during a surgical procedure the index finger may be used tocontrol the rotation of the elongated shaft assembly 14 to locate thejaws of the end effector assembly 26 in a suitable orientation. Themiddle and/or the other lower fingers may be used to squeeze the trigger32 and grasp tissue within the jaws. Once the jaws are located in thedesired position and the jaws are clamped against the tissue, the indexfinger can be used to activate the toggle switch 30 to adjust the powerlevel of the ultrasonic transducer 16 to treat the tissue. Once thetissue has been treated, the user may release the trigger 32 by pushingoutwardly in the distal direction against the elongated trigger hook 36with the middle and/or lower fingers to open the jaws of the endeffector assembly 26. This basic procedure may be performed without theuser having to adjust their grip of the handle assembly 12.

FIGS. 3-4 illustrate the connection of the elongated endoscopic shaftassembly 14 relative to the end effector assembly 26. As previouslydescribed, in the illustrated embodiment, the end effector assembly 26comprises a clamp arm assembly 64 and a blade 66 to form the jaws of theclamping mechanism. The blade 66 may be an ultrasonically actuatableblade acoustically coupled to the ultrasonic transducer 16. The trigger32 is mechanically connected to a drive assembly. Together, the trigger32 and the drive assembly mechanically cooperate to move the clamp armassembly 64 to an open position in direction 62A wherein the clamp armassembly 64 and the blade 66 are disposed in spaced relation relative toone another, to a clamped or closed position in direction 62B whereinthe clamp arm assembly 64 and the blade 66 cooperate to grasp tissuetherebetween. The clamp arm assembly 64 may comprise a clamp pad (notshown) to engage tissue between the blade 66 and the clamp arm 64. Thedistal end of the tubular reciprocating tubular actuating member 58 ismechanically engaged to the end effector assembly 26. In the illustratedembodiment, the distal end of the tubular reciprocating tubularactuating member 58 is mechanically engaged to the clamp arm assembly64, which is pivotable about the pivot point 70, to open and close theclamp arm assembly 64 in response to the actuation and/or release of thetrigger 32. For example, in the illustrated embodiment, the clamp armassembly 64 is movable from an open position to a closed position indirection 62B about a pivot point 70 when the trigger 32 is squeezed indirection 33A. The clamp arm assembly 64 is movable from a closedposition to an open position in direction 62B about the pivot point 70when the trigger 32 is released or outwardly contacted in direction 33B.

As previously discussed, the clamp arm assembly 64 may compriseelectrodes electrically coupled to the electrosurgical/RF generatormodule 23 to receive therapeutic and/or sub-therapeutic energy, wherethe electrosurgical/RF energy may be applied to the electrodes eithersimultaneously or non-simultaneously with the ultrasonic energy beingapplied to the blade 66. Such energy activations may be applied in anysuitable combinations to achieve a desired tissue effect in cooperationwith an algorithm or other control logic.

FIG. 5 is an exploded view of the ultrasonic surgical instrument 10shown in FIG. 2. In the illustrated embodiment, the exploded view showsthe internal elements of the handle assembly 12, the handle assembly 12,the distal rotation assembly 13, the switch assembly 28, and theelongated endoscopic shaft assembly 14. In the illustrated embodiment,the first and second portions 12 a, 12 b mate to form the handleassembly 12. The first and second portions 12 a, 12 b each comprises aplurality of interfaces 69 dimensioned to mechanically align and engageone another to form the handle assembly 12 and enclose the internalworking components of the ultrasonic surgical instrument 10. Therotation knob 48 is mechanically engaged to the outer tubular sheath 56so that it may be rotated in circular direction 54 up to 360°. The outertubular sheath 56 is located over the reciprocating tubular actuatingmember 58, which is mechanically engaged to and retained within thehandle assembly 12 via a plurality of coupling elements 72. The couplingelements 72 may comprise an O-ring 72 a, a tube collar cap 72 b, adistal washer 72 c, a proximal washer 72 d, and a thread tube collar 72e. The reciprocating tubular actuating member 58 is located within areciprocating yoke 84, which is retained between the first and secondportions 12 a, 12 b of the handle assembly 12. The yoke 84 is part of areciprocating yoke assembly 88. A series of linkages translate thepivotal rotation of the elongated trigger hook 32 to the axial movementof the reciprocating yoke 84, which controls the opening and closing ofthe jaws of the clamping mechanism of the end effector assembly 26 atthe distal end of the ultrasonic surgical instrument 10. In one exampleembodiment, a four-link design provides mechanical advantage in arelatively short rotation span, for example.

In one example embodiment, an ultrasonic transmission waveguide 78 isdisposed inside the reciprocating tubular actuating member 58. Thedistal end 52 of the ultrasonic transmission waveguide 78 isacoustically coupled (e.g., directly or indirectly mechanically coupled)to the blade 66 and the proximal end 50 of the ultrasonic transmissionwaveguide 78 is received within the handle assembly 12. The proximal end50 of the ultrasonic transmission waveguide 78 is adapted toacoustically couple to the distal end of the ultrasonic transducer 16 asdiscussed in more detail below. The ultrasonic transmission waveguide 78is isolated from the other elements of the elongated shaft assembly 14by a protective sheath 80 and a plurality of isolation elements 82, suchas silicone rings. The outer tubular sheath 56, the reciprocatingtubular actuating member 58, and the ultrasonic transmission waveguide78 are mechanically engaged by a pin 74. The switch assembly 28comprises the toggle switch 30 and electrical elements 86 a,b toelectrically energize the ultrasonic transducer 16 in accordance withthe activation of the first or second projecting knobs 30 a, 30 b.

In one example embodiment, the outer tubular sheath 56 isolates the useror the patient from the ultrasonic vibrations of the ultrasonictransmission waveguide 78. The outer tubular sheath 56 generallyincludes a hub 76. The outer tubular sheath 56 is threaded onto thedistal end of the handle assembly 12. The ultrasonic transmissionwaveguide 78 extends through the opening of the outer tubular sheath 56and the isolation elements 82 isolate the ultrasonic transmissionwaveguide 78 from the outer tubular sheath 56. The outer tubular sheath56 may be attached to the waveguide 78 with the pin 74. The hole toreceive the pin 74 in the waveguide 78 may occur nominally at adisplacement node. The waveguide 78 may screw or snap into the handpiece handle assembly 12 by a stud. Flat portions on the hub 76 mayallow the assembly to be torqued to a required level. In one exampleembodiment, the hub 76 portion of the outer tubular sheath 56 ispreferably constructed from plastic and the tubular elongated portion ofthe outer tubular sheath 56 is fabricated from stainless steel.Alternatively, the ultrasonic transmission waveguide 78 may comprisepolymeric material surrounding it to isolate it from outside contact.

In one example embodiment, the distal end of the ultrasonic transmissionwaveguide 78 may be coupled to the proximal end of the blade 66 by aninternal threaded connection, preferably at or near an antinode. It iscontemplated that the blade 66 may be attached to the ultrasonictransmission waveguide 78 by any suitable means, such as a welded jointor the like. Although the blade 66 may be detachable from the ultrasonictransmission waveguide 78, it is also contemplated that the singleelement end effector (e.g., the blade 66) and the ultrasonictransmission waveguide 78 may be formed as a single unitary piece.

In one example embodiment, the trigger 32 is coupled to a linkagemechanism to translate the rotational motion of the trigger 32 indirections 33A and 33B to the linear motion of the reciprocating tubularactuating member 58 in corresponding directions 60A and 60B. The trigger32 comprises a first set of flanges 97 with openings formed therein toreceive a first yoke pin 94 a. The first yoke pin 94 a is also locatedthrough a set of openings formed at the distal end of the yoke 84. Thetrigger 32 also comprises a second set of flanges 96 to receive a firstend 92 a of a link 92. A trigger pin 90 is received in openings formedin the link 92 and the second set of flanges 96. The trigger pin 90 isreceived in the openings formed in the link 92 and the second set offlanges 96 and is adapted to couple to the first and second portions 12a, 12 b of the handle assembly 12 to form a trigger pivot point for thetrigger 32. A second end 92 b of the link 92 is received in a slot 93formed in a proximal end of the yoke 84 and is retained therein by asecond yoke pin 94 b. As the trigger 32 is pivotally rotated about thepivot point 190 formed by the trigger pin 90, the yoke translateshorizontally along longitudinal axis “T” in a direction indicated byarrows 60A,B.

FIG. 8 illustrates one example embodiment of an ultrasonic surgicalinstrument 10. In the illustrated embodiment, a cross-sectional view ofthe ultrasonic transducer 16 is shown within a partial cutaway view ofthe handle assembly 12. One example embodiment of the ultrasonicsurgical instrument 10 comprises the ultrasonic signal generator 20coupled to the ultrasonic transducer 16, comprising a hand piece housing99, and an ultrasonically actuatable single or multiple element endeffector assembly 26. As previously discussed, the end effector assembly26 comprises the ultrasonically actuatable blade 66 and the clamp arm64. The ultrasonic transducer 16, which is known as a “Langevin stack”,generally includes a transduction portion 100, a first resonator portionor end-bell 102, and a second resonator portion or fore-bell 104, andancillary components. The total construction of these components is aresonator. The ultrasonic transducer 16 is preferably an integral numberof one-half system wavelengths (nλ/2; where “n” is any positive integer;e.g., n=1, 2, 3 . . . ) in length as will be described in more detaillater. An acoustic assembly 106 includes the ultrasonic transducer 16, anose cone 108, a velocity transformer 118, and a surface 110.

In one example embodiment, the distal end of the end-bell 102 isconnected to the proximal end of the transduction portion 100, and theproximal end of the fore-bell 104 is connected to the distal end of thetransduction portion 100. The fore-bell 104 and the end-bell 102 have alength determined by a number of variables, including the thickness ofthe transduction portion 100, the density and modulus of elasticity ofthe material used to manufacture the end-bell 102 and the fore-bell 22,and the resonant frequency of the ultrasonic transducer 16. Thefore-bell 104 may be tapered inwardly from its proximal end to itsdistal end to amplify the ultrasonic vibration amplitude as the velocitytransformer 118, or alternately may have no amplification. A suitablevibrational frequency range may be about 20 Hz to 32 kHz and awell-suited vibrational frequency range may be about 30-10 kHz. Asuitable operational vibrational frequency may be approximately 55.5kHz, for example.

In one example embodiment, the piezoelectric elements 112 may befabricated from any suitable material, such as, for example, leadzirconate-titanate, lead meta-niobate, lead titanate, barium titanate,or other piezoelectric ceramic material. Each of positive electrodes114, negative electrodes 116, and the piezoelectric elements 112 has abore extending through the center. The positive and negative electrodes114 and 116 are electrically coupled to wires 120 and 122, respectively.The wires 120 and 122 are encased within the cable 22 and electricallyconnectable to the ultrasonic signal generator 20.

The ultrasonic transducer 16 of the acoustic assembly 106 converts theelectrical signal from the ultrasonic signal generator 20 intomechanical energy that results in primarily a standing acoustic wave oflongitudinal vibratory motion of the ultrasonic transducer 16 and theblade 66 portion of the end effector assembly 26 at ultrasonicfrequencies. In another embodiment, the vibratory motion of theultrasonic transducer may act in a different direction. For example, thevibratory motion may comprise a local longitudinal component of a morecomplicated motion of the tip of the elongated shaft assembly 14. Asuitable generator is available as model number GEN11, from EthiconEndo-Surgery, Inc., Cincinnati, Ohio. When the acoustic assembly 106 isenergized, a vibratory motion standing wave is generated through theacoustic assembly 106. The ultrasonic surgical instrument 10 is designedto operate at a resonance such that an acoustic standing wave pattern ofpredetermined amplitude is produced. The amplitude of the vibratorymotion at any point along the acoustic assembly 106 depends upon thelocation along the acoustic assembly 106 at which the vibratory motionis measured. A minimum or zero crossing in the vibratory motion standingwave is generally referred to as a node (i.e., where motion is minimal),and a local absolute value maximum or peak in the standing wave isgenerally referred to as an anti-node (e.g., where local motion ismaximal). The distance between an anti-node and its nearest node isone-quarter wavelength (λ/4).

The wires 120 and 122 transmit an electrical signal from the ultrasonicsignal generator 20 to the positive electrodes 114 and the negativeelectrodes 116. The piezoelectric elements 112 are energized by theelectrical signal supplied from the ultrasonic signal generator 20 inresponse to an actuator 224, such as a foot switch, for example, toproduce an acoustic standing wave in the acoustic assembly 106. Theelectrical signal causes disturbances in the piezoelectric elements 112in the form of repeated small displacements resulting in largealternating compression and tension forces within the material. Therepeated small displacements cause the piezoelectric elements 112 toexpand and contract in a continuous manner along the axis of the voltagegradient, producing longitudinal waves of ultrasonic energy. Theultrasonic energy is transmitted through the acoustic assembly 106 tothe blade 66 portion of the end effector assembly 26 via a transmissioncomponent or an ultrasonic transmission waveguide portion 78 of theelongated shaft assembly 14.

In one example embodiment, in order for the acoustic assembly 106 todeliver energy to the blade 66 portion of the end effector assembly 26,all components of the acoustic assembly 106 must be acoustically coupledto the blade 66. The distal end of the ultrasonic transducer 16 may beacoustically coupled at the surface 110 to the proximal end of theultrasonic transmission waveguide 78 by a threaded connection such as astud 124.

In one example embodiment, the components of the acoustic assembly 106are preferably acoustically tuned such that the length of any assemblyis an integral number of one-half wavelengths (nλ/2), where thewavelength λ is the wavelength of a pre-selected or operatinglongitudinal vibration drive frequency f_(d) of the acoustic assembly106. It is also contemplated that the acoustic assembly 106 mayincorporate any suitable arrangement of acoustic elements.

In one example embodiment, the blade 66 may have a length substantiallyequal to an integral multiple of one-half system wavelengths (nλ/2). Adistal end of the blade 66 may be disposed near an antinode in order toprovide the maximum longitudinal excursion of the distal end. When thetransducer assembly is energized, the distal end of the blade 66 may beconfigured to move in the range of, for example, approximately 10 to 500microns peak-to-peak, and preferably in the range of about 30 to 64microns at a predetermined vibrational frequency of 55 kHz, for example.

In one example embodiment, the blade 66 may be coupled to the ultrasonictransmission waveguide 78. The blade 66 and the ultrasonic transmissionwaveguide 78 as illustrated are formed as a single unit constructionfrom a material suitable for transmission of ultrasonic energy. Examplesof such materials include Ti6Al4V (an alloy of Titanium includingAluminum and Vanadium), Aluminum, Stainless Steel, or other suitablematerials. Alternately, the blade 66 may be separable (and of differingcomposition) from the ultrasonic transmission waveguide 78, and coupledby, for example, a stud, weld, glue, quick connect, or other suitableknown methods. The length of the ultrasonic transmission waveguide 78may be substantially equal to an integral number of one-half wavelengths(nλ/2), for example. The ultrasonic transmission waveguide 78 may bepreferably fabricated from a solid core shaft constructed out ofmaterial suitable to propagate ultrasonic energy efficiently, such asthe titanium alloy discussed above (i.e., Ti6Al4V) or any suitablealuminum alloy, or other alloys, for example.

In one example embodiment, the ultrasonic transmission waveguide 78comprises a longitudinally projecting attachment post at a proximal endto couple to the surface 110 of the ultrasonic transmission waveguide 78by a threaded connection such as the stud 124. The ultrasonictransmission waveguide 78 may include a plurality of stabilizingsilicone rings or compliant supports 82 (FIG. 5) positioned at aplurality of nodes. The silicone rings 82 dampen undesirable vibrationand isolate the ultrasonic energy from an outer protective sheath 80(FIG. 5) assuring the flow of ultrasonic energy in a longitudinaldirection to the distal end of the blade 66 with maximum efficiency.

FIG. 9 illustrates one example embodiment of the proximal rotationassembly 128. In the illustrated embodiment, the proximal rotationassembly 128 comprises the proximal rotation knob 134 inserted over thecylindrical hub 135. The proximal rotation knob 134 comprises aplurality of radial projections 138 that are received in correspondingslots 130 formed on a proximal end of the cylindrical hub 135. Theproximal rotation knob 134 defines an opening 142 to receive the distalend of the ultrasonic transducer 16. The radial projections 138 areformed of a soft polymeric material and define a diameter that isundersized relative to the outside diameter of the ultrasonic transducer16 to create a friction interference fit when the distal end of theultrasonic transducer 16. The polymeric radial projections 138 protruderadially into the opening 142 to form “gripper” ribs that firmly gripthe exterior housing of the ultrasonic transducer 16. Therefore, theproximal rotation knob 134 securely grips the ultrasonic transducer 16.

The distal end of the cylindrical hub 135 comprises a circumferentiallip 132 and a circumferential bearing surface 140. The circumferentiallip engages a groove formed in the housing 12 and the circumferentialbearing surface 140 engages the housing 12. Thus, the cylindrical hub135 is mechanically retained within the two housing portions (not shown)of the housing 12. The circumferential lip 132 of the cylindrical hub135 is located or “trapped” between the first and second housingportions 12 a, 12 b and is free to rotate in place within the groove.The circumferential bearing surface 140 bears against interior portionsof the housing to assist proper rotation. Thus, the cylindrical hub 135is free to rotate in place within the housing. The user engages theflutes 136 formed on the proximal rotation knob 134 with either thefinger or the thumb to rotate the cylindrical hub 135 within the housing12.

In one example embodiment, the cylindrical hub 135 may be formed of adurable plastic such as polycarbonate. In one example embodiment, thecylindrical hub 135 may be formed of a siliconized polycarbonatematerial. In one example embodiment, the proximal rotation knob 134 maybe formed of pliable, resilient, flexible polymeric materials includingVersaflex® TPE alloys made by GLS Corporation, for example. The proximalrotation knob 134 may be formed of elastomeric materials, thermoplasticrubber known as Santoprene®, other thermoplastic vulcanizates (TPVs), orelastomers, for example. The embodiments, however, are not limited inthis context.

FIG. 10 illustrates one example embodiment of a surgical system 200including a surgical instrument 210 having single element end effector278. The system 200 may include a transducer assembly 216 coupled to theend effector 278 and a sheath 256 positioned around the proximalportions of the end effector 278 as shown. The transducer assembly 216and end effector 278 may operate in a manner similar to that of thetransducer assembly 16 and end effector 18 described above to produceultrasonic energy that may be transmitted to tissue via blade 226.

FIGS. 11-18C illustrate various embodiments of surgical instruments thatutilize therapeutic and/or subtherapeutic electrical energy to treattissue or provide feedback to the generators (e.g., electrosurgicalinstruments). The embodiments of FIGS. 11-18C are adapted for use in amanual or hand-operated manner, although electrosurgical instruments maybe utilized in robotic applications as well. FIG. 11 is a perspectiveview of one example embodiment of a surgical instrument system 300comprising an electrical energy surgical instrument 310. Theelectrosurgical instrument 310 may comprise a proximal handle 312, adistal working end or end effector 326 and an introducer or elongatedshaft 314 disposed in-between.

The electrosurgical system 300 can be configured to supply energy, suchas electrical energy, ultrasonic energy, heat energy or any combinationthereof, to the tissue of a patient either independently orsimultaneously as described, for example, in connection with FIG. 1, forexample. In one example embodiment, the electrosurgical system 300includes a generator 320 in electrical communication with theelectrosurgical instrument 310. The generator 320 is connected toelectrosurgical instrument 310 via a suitable transmission medium suchas a cable 322. In one example embodiment, the generator 320 is coupledto a controller, such as a control unit 325, for example. In variousembodiments, the control unit 325 may be formed integrally with thegenerator 320 or may be provided as a separate circuit module or deviceelectrically coupled to the generator 320 (shown in phantom as 325′ toillustrate this option). Although in the presently disclosed embodiment,the generator 320 is shown separate from the electrosurgical instrument310, in one example embodiment, the generator 320 (and/or the controlunit 325) may be formed integrally with the electrosurgical instrument310 to form a unitary electrosurgical system 300, where a batterylocated within the electrosurgical instrument 310 is the energy sourceand a circuit coupled to the battery produces the suitable electricalenergy, ultrasonic energy, or heat energy. One such example is describedherein below in connection with FIGS. 17-18C.

The generator 320 may comprise an input device 335 located on a frontpanel of the generator 320 console. The input device 335 may compriseany suitable device that generates signals suitable for programming theoperation of the generator 320, such as a keyboard, or input port, forexample. In one example embodiment, various electrodes in the first jaw364A and the second jaw 364B may be coupled to the generator 320. Thecable 322 may comprise multiple electrical conductors for theapplication of electrical energy to positive (+) and negative (−)electrodes of the electrosurgical instrument 310. The control unit 325may be used to activate the generator 320, which may serve as anelectrical source. In various embodiments, the generator 320 maycomprise an RF source, an ultrasonic source, a direct current source,and/or any other suitable type of electrical energy source, for example,which may be activated independently or simultaneously.

In various embodiments, the electrosurgical system 300 may comprise atleast one supply conductor 331 and at least one return conductor 333,wherein current can be supplied to electrosurgical instrument 300 viathe supply conductor 331 and wherein the current can flow back to thegenerator 320 via the return conductor 333. In various embodiments, thesupply conductor 331 and the return conductor 333 may comprise insulatedwires and/or any other suitable type of conductor. In certainembodiments, as described below, the supply conductor 331 and the returnconductor 333 may be contained within and/or may comprise the cable 322extending between, or at least partially between, the generator 320 andthe end effector 326 of the electrosurgical instrument 310. In anyevent, the generator 320 can be configured to apply a sufficient voltagedifferential between the supply conductor 331 and the return conductor333 such that sufficient current can be supplied to the end effector110.

FIG. 12 is a side view of one example embodiment of the handle 312 ofthe surgical instrument 310. In FIG. 12, the handle 312 is shown withhalf of a first handle body 312A (see FIG. 11) removed to illustratevarious components within second handle body 312B. The handle 312 maycomprise a lever arm 321 (e.g., a trigger) which may be pulled along apath 33. The lever arm 321 may be coupled to an axially moveable member378 (FIGS. 13-16) disposed within elongated shaft 314 by a shuttle 384operably engaged to an extension 398 of lever arm 321. The shuttle 384may further be connected to a biasing device, such as a spring 388,which may also be connected to the second handle body 312B, to bias theshuttle 384 and thus the axially moveable member 378 in a proximaldirection, thereby urging the jaws 364A and 364B to an open position asseen in FIG. 11. Also, referring to FIGS. 11-12, a locking member 190(see FIG. 12) may be moved by a locking switch 328 (see FIG. 11) betweena locked position, where the shuttle 384 is substantially prevented frommoving distally as illustrated, and an unlocked position, where theshuttle 384 may be allowed to freely move in the distal direction,toward the elongated shaft 314. In some embodiments, the locking switch328 may be implemented as a button. The handle 312 can be any type ofpistol-grip or other type of handle known in the art that is configuredto carry actuator levers, triggers or sliders for actuating the firstjaw 364A and the second jaw 364B. The elongated shaft 314 may have acylindrical or rectangular cross-section, for example, and can comprisea thin-wall tubular sleeve that extends from handle 312. The elongatedshaft 314 may include a bore extending therethrough for carryingactuator mechanisms, for example, the axially moveable member 378, foractuating the jaws and for carrying electrical leads for delivery ofelectrical energy to electrosurgical components of the end effector 326.

The end effector 326 may be adapted for capturing and transecting tissueand for the contemporaneously welding the captured tissue withcontrolled application of energy (e.g., RF energy). The first jaw 364Aand the second jaw 364B may close to thereby capture or engage tissueabout a longitudinal axis “T” defined by the axially moveable member378. The first jaw 364A and second jaw 364B may also apply compressionto the tissue. In some embodiments, the elongated shaft 314, along withfirst jaw 364A and second jaw 364B, can be rotated a full 360° degrees,as shown by arrow 196 (see FIG. 11), relative to handle 312. Forexample, a rotation knob 348 may be rotatable about the longitudinalaxis of the shaft 314 and may be coupled to the shaft 314 such thatrotation of the knob 348 causes corresponding rotation of the shaft 314.The first jaw 364A and the second jaw 364B can remain openable and/orcloseable while rotated.

FIG. 13 shows a perspective view of one example embodiment of the endeffector 326 with the jaws 364A, 364B open, while FIG. 14 shows aperspective view of one example embodiment of the end effector 326 withthe jaws 364A, 364B closed. As noted above, the end effector 326 maycomprise the upper first jaw 364A and the lower second jaw 364B, whichmay be straight or curved. The first jaw 364A and the second jaw 364Bmay each comprise an elongated slot or channel 362A and 362B,respectively, disposed outwardly along their respective middle portions.Further, the first jaw 364A and second jaw 364B may each havetissue-gripping elements, such as teeth 363, disposed on the innerportions of first jaw 364A and second jaw 364B. The first jaw 364A maycomprise an upper first outward-facing surface 369A and an upper firstenergy delivery surface 365A. The second jaw 364B may comprise a lowersecond outward-facing surface 369B and a lower second energy deliverysurface 365B. The first energy delivery surface 365A and the secondenergy delivery surface 365B may both extend in a “U” shape about thedistal end of the end effector 326.

The lever arm 321 of the handle 312 (FIG. 12) may be adapted to actuatethe axially moveable member 378, which may also function as ajaw-closing mechanism. For example, the axially moveable member 378 maybe urged distally as the lever arm 321 is pulled proximally along thepath 33 via the shuttle 384, as shown in FIG. 12 and discussed above.FIG. 15 is a perspective view of one example embodiment of the axiallymoveable member 378 of the surgical instrument 310. The axially moveablemember 378 may comprise one or several pieces, but in any event, may bemovable or translatable with respect to the elongated shaft 314 and/orthe jaws 364A, 364B. Also, in at least one example embodiment, theaxially moveable member 378 may be made of 17-4 precipitation hardenedstainless steel. The distal end of axially moveable member 378 maycomprise a flanged “I”-beam configured to slide within the channels 362Aand 362B in jaws 364A and 364B. The axially moveable member 378 mayslide within the channels 362A, 362B to open and close the first jaw364A and the second jaw 364B. The distal end of the axially moveablemember 378 may also comprise an upper flange or “c”-shaped portion 378Aand a lower flange or “c”-shaped portion 378B. The flanges 378A and 378Brespectively define inner cam surfaces 367A and 367B for engagingoutward facing surfaces of the first jaw 364A and the second jaw 364B.The opening-closing of jaws 364A and 364B can apply very highcompressive forces on tissue using cam mechanisms which may includemovable “I-beam” axially moveable member 378 and the outward facingsurfaces 369A, 369B of jaws 364A, 364B.

More specifically, referring now to FIGS. 13-15, collectively, the innercam surfaces 367A and 367B of the distal end of axially moveable member378 may be adapted to slidably engage the first outward-facing surface369A and the second outward-facing surface 369B of the first jaw 364Aand the second jaw 364B, respectively. The channel 362A within first jaw364A and the channel 362B within the second jaw 364B may be sized andconfigured to accommodate the movement of the axially moveable member378, which may comprise a tissue-cutting element 371, for example,comprising a sharp distal edge. FIG. 14, for example, shows the distalend of the axially moveable member 378 advanced at least partiallythrough channels 362A and 362B (FIG. 13). The advancement of the axiallymoveable member 378 may close the end effector 326 from the openconfiguration shown in FIG. 13. In the closed position shown by FIG. 14,the upper first jaw 364A and lower second jaw 364B define a gap ordimension D between the first energy delivery surface 365A and secondenergy delivery surface 365B of first jaw 364A and second jaw 364B,respectively. In various embodiments, dimension D can equal from about0.0005″ to about 0.040″, for example, and in some embodiments, betweenabout 0.001″ to about 0.010″, for example. Also, the edges of the firstenergy delivery surface 365A and the second energy delivery surface 365Bmay be rounded to prevent the dissection of tissue.

FIG. 16 is a section view of one example embodiment of the end effector326 of the surgical instrument 310. The engagement, ortissue-contacting, surface 365B of the lower jaw 364B is adapted todeliver energy to tissue, at least in part, through aconductive-resistive matrix, such as a variable resistive positivetemperature coefficient (PTC) body, as discussed in more detail below.At least one of the upper and lower jaws 364A, 364B may carry at leastone electrode 373 configured to deliver the energy from the generator320 to the captured tissue. The engagement, or tissue-contacting,surface 365A of upper jaw 364A may carry a similar conductive-resistivematrix (i.e., a PTC material), or in some embodiments the surface may bea conductive electrode or an insulative layer, for example.Alternatively, the engagement surfaces of the jaws can carry any of theenergy delivery components disclosed in U.S. Pat. No. 6,773,409, filedOct. 22, 2001, entitled ELECTROSURGICAL JAW STRUCTURE FOR CONTROLLEDENERGY DELIVERY, the entire disclosure of which is incorporated hereinby reference.

The first energy delivery surface 365A and the second energy deliverysurface 365B may each be in electrical communication with the generator320. The first energy delivery surface 365A and the second energydelivery surface 365B may be configured to contact tissue and deliverelectrosurgical energy to captured tissue which are adapted to seal orweld the tissue. The control unit 325 regulates the electrical energydelivered by electrical generator 320 which in turn deliverselectrosurgical energy to the first energy delivery surface 365A and thesecond energy delivery surface 365B. The energy delivery may beinitiated by an activation button 328 (FIG. 12) operably engaged withthe lever arm 321 and in electrical communication with the generator 320via cable 322. In one example embodiment, the electrosurgical instrument310 may be energized by the generator 320 by way of a foot switch 329(FIG. 11). When actuated, the foot switch 329 triggers the generator 320to deliver electrical energy to the end effector 326, for example. Thecontrol unit 325 may regulate the power generated by the generator 320during activation. Although the foot switch 329 may be suitable in manycircumstances, other suitable types of switches can be used.

As mentioned above, the electrosurgical energy delivered by electricalgenerator 320 and regulated, or otherwise controlled, by the controlunit 325 may comprise radio frequency (RF) energy, or other suitableforms of electrical energy. Further, the opposing first and secondenergy delivery surfaces 365A and 365B may carry variable resistivepositive temperature coefficient (PTC) bodies that are in electricalcommunication with the generator 320 and the control unit 325.Additional details regarding electrosurgical end effectors, jaw closingmechanisms, and electrosurgical energy-delivery surfaces are describedin the following U.S. patents and published patent applications: U.S.Pat. Nos. 7,087,054; 7,083,619; 7,070,597; 7,041,102; 7,011,657;6,929,644; 6,926,716; 6,913,579; 6,905,497; 6,802,843; 6,770,072;6,656,177; 6,533,784; and 6,500,312; and U.S. Pat. App. Pub. Nos.2010/0036370 and 2009/0076506, all of which are incorporated herein intheir entirety by reference and made a part of this specification.

In one example embodiment, the generator 320 may be implemented as anelectrosurgery unit (ESU) capable of supplying power sufficient toperform bipolar electrosurgery using radio frequency (RF) energy. In oneexample embodiment, the ESU can be a bipolar ERBE ICC 350 sold by ERBEUSA, Inc. of Marietta, Ga. In some embodiments, such as for bipolarelectrosurgery applications, a surgical instrument having an activeelectrode and a return electrode can be utilized, wherein the activeelectrode and the return electrode can be positioned against, adjacentto and/or in electrical communication with, the tissue to be treatedsuch that current can flow from the active electrode, through thepositive temperature coefficient (PTC) bodies and to the returnelectrode through the tissue. Thus, in various embodiments, theelectrosurgical system 300 may comprise a supply path and a return path,wherein the captured tissue being treated completes, or closes, thecircuit. In one example embodiment, the generator 320 may be a monopolarRF ESU and the electrosurgical instrument 310 may comprise a monopolarend effector 326 in which one or more active electrodes are integrated.For such a system, the generator 320 may require a return pad inintimate contact with the patient at a location remote from theoperative site and/or other suitable return path. The return pad may beconnected via a cable to the generator 320. In other embodiments, theoperator 20 may provide subtherapeutic RF energy levels for purposes ofevaluating tissue conditions and providing feedback n theelectrosurgical system 300. Such feed back may be employed to controlthe therapeutic RF energy output of the electrosurgical instrument 310.

During operation of electrosurgical instrument 300, the user generallygrasps tissue, supplies energy to the captured tissue to form a weld ora seal (e.g., by actuating button 328 and/or pedal 216), and then drivesa tissue-cutting element 371 at the distal end of the axially moveablemember 378 through the captured tissue. According to variousembodiments, the translation of the axial movement of the axiallymoveable member 378 may be paced, or otherwise controlled, to aid indriving the axially moveable member 378 at a suitable rate of travel. Bycontrolling the rate of the travel, the likelihood that the capturedtissue has been properly and functionally sealed prior to transectionwith the cutting element 371 is increased.

FIG. 17 is a perspective view of one example embodiment of a surgicalinstrument system comprising a cordless electrical energy surgicalinstrument 410. The electrosurgical system is similar to theelectrosurgical system 300. The electrosurgical system can be configuredto supply energy, such as electrical energy, ultrasonic energy, heatenergy, or any combination thereof, to the tissue of a patient eitherindependently or simultaneously as described in connection with FIGS. 1and 11, for example. The electrosurgical instrument may utilize the endeffector 326 and elongated shaft 314 described here in conjunction witha cordless proximal handle 412. In one example embodiment, the handle412 includes a generator circuit 420 (see FIG. 18A). The generatorcircuit 420 performs a function substantially similar to that ofgenerator 320. In one example embodiment, the generator circuit 420 iscoupled to a controller, such as a control circuit. In the illustratedembodiment, the control circuit is integrated into the generator circuit420. In other embodiments, the control circuit may be separate from thegenerator circuit 420.

In one example embodiment, various electrodes in the end effector 326(including jaws 364A, 364B thereof) may be coupled to the generatorcircuit 420. The control circuit may be used to activate the generator420, which may serve as an electrical source. In various embodiments,the generator 420 may comprise an RF source, an ultrasonic source, adirect current source, and/or any other suitable type of electricalenergy source, for example. In one example embodiment, a button 328 maybe provided to activate the generator circuit 420 to provide energy tothe end effectors 326, 326.

FIG. 18A is a side view of one example embodiment of the handle 412 ofthe cordless surgical instrument 410. In FIG. 18A, the handle 412 isshown with half of a first handle body removed to illustrate variouscomponents within second handle body 434. The handle 412 may comprise alever arm 424 (e.g., a trigger) which may be pulled along a path 33around a pivot point. The lever arm 424 may be coupled to an axiallymoveable member 478 disposed within elongated shaft 314 by a shuttleoperably engaged to an extension of lever arm 424. In one exampleembodiment, the lever arm 424 defines a shepherd's hook shape comprisinga distal trigger hook 424 a and a proximal trigger portion 424 b. Asillustrated, the distal trigger hook 424 a may have a first length whilethe proximal trigger portion 424 may have a second length with thesecond length greater than the first length.

In one example embodiment, the cordless electrosurgical instrumentcomprises a battery 437. The battery 437 provides electrical energy tothe generator circuit 420. The battery 437 may be any battery suitablefor driving the generator circuit 420 at the desired energy levels. Inone example embodiment, the battery 437 is a 1030 mAhr, triple-cellLithium Ion Polymer battery. The battery may be fully charged prior touse in a surgical procedure, and may hold a voltage of about 12.6V. Thebattery 437 may have two fuses fitted to the cordless electrosurgicalinstrument 410, arranged in line with each battery terminal. In oneexample embodiment, a charging port 439 is provided to connect thebattery 437 to a DC current source (not shown).

The generator circuit 420 may be configured in any suitable manner. Insome embodiments, the generator circuit comprises an RF drive andcontrol circuit 440. FIG. 18B illustrates an RF drive and controlcircuit 440, according to one embodiment. FIG. 18B is a part schematicpart block diagram illustrating the RF drive and control circuitry 440used in this embodiment to generate and control the RF electrical energysupplied to the end effector 326. As will be explained in more detailbelow, in this embodiment, the drive circuitry 440 is a resonant mode RFamplifier comprising a parallel resonant network on the RF amplifieroutput and the control circuitry operates to control the operatingfrequency of the drive signal so that it is maintained at the resonantfrequency of the drive circuit, which in turn controls the amount ofpower supplied to the end effector 326. The way that this is achievedwill become apparent from the following description.

As shown in FIG. 18B, the RF drive and control circuit 440 comprises theabove described battery 437 are arranged to supply, in this example,about 0V and about 12V rails. An input capacitor (C_(in)) 442 isconnected between the 0V and the 12V for providing a low sourceimpedance. A pair of FET switches 443-1 and 443-2 (both of which areN-channel in this embodiment to reduce power losses) is connected inseries between the 0V rail and the 12V rail. FET gate drive circuitry445 is provided that generates two drive signals—one for driving each ofthe two FETs 443. The FET gate drive circuitry 445 generates drivesignals that causes the upper FET (443-1) to be on when the lower FET(443-2) is off and vice versa. This causes the node 447 to bealternately connected to the 12V rail (when the FET 443-1 is switchedon) and the 0V rail (when the FET 443-2 is switched on). FIG. 18B alsoshows the internal parasitic diodes 448-1 and 448-2 of the correspondingFETs 443, which conduct during any periods that the FETs 443 are open.

As shown in FIG. 18B, the node 447 is connected to an inductor-inductorresonant circuit 450 formed by inductor L_(s) 452 and inductor L_(m)454. The FET gate driving circuitry 445 is arranged to generate drivesignals at a drive frequency (f_(d)) that opens and crosses the FETswitches 443 at the resonant frequency of the parallel resonant circuit450. As a result of the resonant characteristic of the resonant circuit450, the square wave voltage at node 447 will cause a substantiallysinusoidal current at the drive frequency (f_(d)) to flow within theresonant circuit 450. As illustrated in FIG. 18B, the inductor L_(m) 454is the primary of a transformer 455, the secondary of which is formed byinductor L_(sec) 456. The inductor L_(sec) 456 of the transformer 455secondary is connected to an inductor-capacitor-capacitor parallelresonant circuit 457 formed by inductor L₂ 458, capacitor C₄ 460, andcapacitor C₂ 462. The transformer 455 up-converts the drive voltage(V_(d)) across the inductor L_(m) 454 to the voltage that is applied tothe output parallel resonant circuit 457. The load voltage (V_(L)) isoutput by the parallel resonant circuit 457 and is applied to the load(represented by the load resistance R_(load) 459 in FIG. 18B)corresponding to the impedance of the forceps' jaws and any tissue orvessel gripped by the end effector 326. As shown in FIG. 18B, a pair ofDC blocking capacitors C_(bl) 480-1 and 480-2 is provided to prevent anyDC signal being applied to the load 459.

In one embodiment, the transformer 455 may be implemented with a CoreDiameter (mm), Wire Diameter (mm), and Gap between secondary windings inaccordance with the following specifications:

Core Diameter, D (mm)

D=19.9×10-3

Wire diameter, W (mm) for 22 AWG wire

W=7.366×10-4

Gap between secondary windings, in gap=0.125

G=gap/25.4

In this embodiment, the amount of electrical power supplied to the endeffector 326 is controlled by varying the frequency of the switchingsignals used to switch the FETs 443. This works because the resonantcircuit 450 acts as a frequency dependent (loss less) attenuator. Thecloser the drive signal is to the resonant frequency of the resonantcircuit 450, the less the drive signal is attenuated. Similarly, as thefrequency of the drive signal is moved away from the resonant frequencyof the circuit 450, the more the drive signal is attenuated and so thepower supplied to the load reduces. In this embodiment, the frequency ofthe switching signals generated by the FET gate drive circuitry 445 iscontrolled by a controller 481 based on a desired power to be deliveredto the load 459 and measurements of the load voltage (V_(L)) and of theload current (I_(L)) obtained by conventional voltage sensing circuitry483 and current sensing circuitry 485. The way that the controller 481operates will be described in more detail below.

In one embodiment, the voltage sensing circuitry 483 and the currentsensing circuitry 485 may be implemented with high bandwidth, high speedrail-to-rail amplifiers (e.g., LM H6643 by National Semiconductor). Suchamplifiers, however, consume a relatively high current when they areoperational. Accordingly, a power save circuit may be provided to reducethe supply voltage of the amplifiers when they are not being used in thevoltage sensing circuitry 483 and the current sensing circuitry 485. Inone-embodiment, a step-down regulator (e.g., LT3502 by LinearTechnologies) may be employed by the power save circuit to reduce thesupply voltage of the rail-to-rail amplifiers and thus extend the lifeof the battery 437.

FIG. 18C illustrates the main components of the controller 481,according to one embodiment. In the embodiment illustrated in FIG. 18C,the controller 481 is a microprocessor based controller and so most ofthe components illustrated in FIG. 16 are software based components.Nevertheless, a hardware based controller 481 may be used instead. Asshown, the controller 481 includes synchronous I,Q sampling circuitry491 that receives the sensed voltage and current signals from thesensing circuitry 483 and 485 and obtains corresponding samples whichare passed to a power, V_(rms) and I_(rms) calculation module 493. Thecalculation module 493 uses the received samples to calculate the RMSvoltage and RMS current applied to the load 459 (FIG. 18B; end effector326 and tissue/vessel gripped thereby) and from them the power that ispresently being supplied to the load 459. The determined values are thenpassed to a frequency control module 495 and a medical device controlmodule 497. The medical device control module 497 uses the values todetermine the present impedance of the load 459 and based on thisdetermined impedance and a pre-defined algorithm, determines what setpoint power (P_(set)) should be applied to the frequency control module495. The medical device control module 497 is in turn controlled bysignals received from a user input module 499 that receives inputs fromthe user (for example pressing buttons or activating the control levers114, 110 on the handle 104) and also controls output devices (lights, adisplay, speaker or the like) on the handle 104 via a user output module461.

The frequency control module 495 uses the values obtained from thecalculation module 493 and the power set point (P_(set)) obtained fromthe medical device control module 497 and predefined system limits (tobe explained below), to determine whether or not to increase or decreasethe applied frequency. The result of this decision is then passed to asquare wave generation module 463 which, in this embodiment, incrementsor decrements the frequency of a square wave signal that it generates by1 kHz, depending on the received decision. As those skilled in the artwill appreciate, in an alternative embodiment, the frequency controlmodule 495 may determine not only whether to increase or decrease thefrequency, but also the amount of frequency change required. In thiscase, the square wave generation module 463 would generate thecorresponding square wave signal with the desired frequency shift. Inthis embodiment, the square wave signal generated by the square wavegeneration module 463 is output to the FET gate drive circuitry 445,which amplifies the signal and then applies it to the FET 443-1. The FETgate drive circuitry 445 also inverts the signal applied to the FET443-1 and applies the inverted signal to the FET 443-2.

The electrosurgical instrument 410 may comprise additional features asdiscussed with respect to electrosurgical system 300. Those skilled inthe art will recognize that electrosurgical instrument 410 may include arotation knob 348, an elongated shaft 314, and an end effector 326.These elements function in a substantially similar manner to thatdiscussed above with respect to the electrosurgical system 300. In oneexample embodiment, the cordless electrosurgical instrument 410 mayinclude visual indicators 435. The visual indicators 435 may provide avisual indication signal to an operator. In one example embodiment, thevisual indication signal may alert an operator that the device is on, orthat the device is applying energy to the end effector. Those skilled inthe art will recognize that the visual indicators 435 may be configuredto provide information on multiple states of the device.

Over the years a variety of minimally invasive robotic (or“telesurgical”) systems have been developed to increase surgicaldexterity as well as to permit a surgeon to operate on a patient in anintuitive manner. Robotic surgical systems can be used with manydifferent types of surgical instruments including, for example,ultrasonic or electrosurgical instruments, as described herein. Examplerobotic systems include those manufactured by Intuitive Surgical, Inc.,of Sunnyvale, Calif., U.S.A. Such systems, as well as robotic systemsfrom other manufacturers, are disclosed in the following U.S. Patentswhich are each herein incorporated by reference in their respectiveentirety: U.S. Pat. No. 5,792,135, entitled “Articulated SurgicalInstrument For Performing Minimally Invasive Surgery With EnhancedDexterity and Sensitivity”, U.S. Pat. No. 6,231,565, entitled “RoboticArm DLUS For Performing Surgical Tasks”, U.S. Pat. No. 6,783,524,entitled “Robotic Surgical Tool With Ultrasound Cauterizing and CuttingInstrument”, U.S. Pat. No. 6,364,888, entitled “Alignment of Master andSlave In a Minimally Invasive Surgical Apparatus”, U.S. Pat. No.7,524,320, entitled “Mechanical Actuator Interface System For RoboticSurgical Tools”, U.S. Pat. No. 7,691,098, entitled Platform Link WristMechanism”, U.S. Pat. No. 7,806,891, entitled “Repositioning andReorientation of Master/Slave Relationship in Minimally InvasiveTelesurgery”, and U.S. Pat. No. 7,824,401, entitled “Surgical Tool WithWrited Monopolar Electrosurgical End Effectors”. Many of such systems,however, have in the past been unable to generate the magnitude offorces required to effectively cut and fasten tissue.

FIGS. 19-46C illustrate example embodiments of robotic surgical systems.In some embodiments, the disclosed robotic surgical systems may utilizethe ultrasonic or electrosurgical instruments described herein. Thoseskilled in the art will appreciate that the illustrated robotic surgicalsystems are not limited to only those instruments described herein, andmay utilize any compatible surgical instruments. Those skilled in theart will further appreciate that while various embodiments describedherein may be used with the described robotic surgical systems, thedisclosure is not so limited, and may be used with any compatiblerobotic surgical system.

FIGS. 19-25 illustrate the structure and operation of several examplerobotic surgical systems and components thereof. FIG. 19 shows a blockdiagram of an example robotic surgical system 500. The system 500comprises at least one controller 508 and at least one arm cart 510. Thearm cart 510 may be mechanically coupled to one or more roboticmanipulators or arms, indicated by box 512. Each of the robotic arms 512may comprise one or more surgical instruments 514 for performing varioussurgical tasks on a patient 504. Operation of the arm cart 510,including the arms 512 and instruments 514 may be directed by aclinician 502 from a controller 508. In some embodiments, a secondcontroller 508′, operated by a second clinician 502′ may also directoperation of the arm cart 510 in conjunction with the first clinician502′. For example, each of the clinicians 502, 502′ may controldifferent arms 512 of the cart or, in some cases, complete control ofthe arm cart 510 may be passed between the clinicians 502, 502′. In someembodiments, additional arm carts (not shown) may be utilized on thepatient 504. These additional arm carts may be controlled by one or moreof the controllers 508, 508′. The arm cart(s) 510 and controllers 508,508′ may be in communication with one another via a communications link516, which may be any suitable type of wired or wireless communicationslink carrying any suitable type of signal (e.g., electrical, optical,infrared, etc.) according to any suitable communications protocol.Example implementations of robotic surgical systems, such as the system500, are disclosed in U.S. Pat. No. 7,524,320 which has been hereinincorporated by reference. Thus, various details of such devices willnot be described in detail herein beyond that which may be necessary tounderstand various embodiments of the claimed device.

FIG. 20 shows one example embodiment of a robotic arm cart 520. Therobotic arm cart 520 is configured to actuate a plurality of surgicalinstruments or instruments, generally designated as 522 within a workenvelope 527. Various robotic surgery systems and methods employingmaster controller and robotic arm cart arrangements are disclosed inU.S. Pat. No. 6,132,368, entitled “Multi-Component Telepresence Systemand Method”, the full disclosure of which is incorporated herein byreference. In various forms, the robotic arm cart 520 includes a base524 from which, in the illustrated embodiment, three surgicalinstruments 522 are supported. In various forms, the surgicalinstruments 522 are each supported by a series of manually articulatablelinkages, generally referred to as set-up joints 526, and a roboticmanipulator 528. These structures are herein illustrated with protectivecovers extending over much of the robotic linkage. These protectivecovers may be optional, and may be limited in size or entirelyeliminated in some embodiments to minimize the inertia that isencountered by the servo mechanisms used to manipulate such devices, tolimit the volume of moving components so as to avoid collisions, and tolimit the overall weight of the cart 520. Cart 520 will generally havedimensions suitable for transporting the cart 520 between operatingrooms. The cart 520 may be configured to typically fit through standardoperating room doors and onto standard hospital elevators. In variousforms, the cart 520 would preferably have a weight and include a wheel(or other transportation) system that allows the cart 520 to bepositioned adjacent an operating table by a single attendant.

FIG. 21 shows one example embodiment of the robotic manipulator 528 ofthe robotic arm cart 520. In the example shown in FIG. 21, the roboticmanipulators 528 may include a linkage 530 that constrains movement ofthe surgical instrument 522. In various embodiments, linkage 530includes rigid links coupled together by rotational joints in aparallelogram arrangement so that the surgical instrument 522 rotatesaround a point in space 532, as more fully described in issued U.S. Pat.No. 5,817,084, the full disclosure of which is herein incorporated byreference. The parallelogram arrangement constrains rotation to pivotingabout an axis 534 a, sometimes called the pitch axis. The linkssupporting the parallelogram linkage are pivotally mounted to set-upjoints 526 (FIG. 20) so that the surgical instrument 522 further rotatesabout an axis 534 b, sometimes called the yaw axis. The pitch and yawaxes 534 a, 534 b intersect at the remote center 536, which is alignedalong a shaft 538 of the surgical instrument 522. The surgicalinstrument 522 may have further degrees of driven freedom as supportedby manipulator 540, including sliding motion of the surgical instrument522 along the longitudinal instrument axis “LT-LT”. As the surgicalinstrument 522 slides along the instrument axis LT-LT relative tomanipulator 540 (arrow 534 c), remote center 536 remains fixed relativeto base 542 of manipulator 540. Hence, the entire manipulator 540 isgenerally moved to re-position remote center 536. Linkage 530 ofmanipulator 540 is driven by a series of motors 544. These motors 544actively move linkage 530 in response to commands from a processor of acontrol system. As will be discussed in further detail below, motors 544are also employed to manipulate the surgical instrument 522.

FIG. 22 shows one example embodiment of a robotic arm cart 520′ havingan alternative set-up joint structure. In this example embodiment, asurgical instrument 522 is supported by an alternative manipulatorstructure 528′ between two tissue manipulation instruments. Those ofordinary skill in the art will appreciate that various embodiments ofthe claimed device may incorporate a wide variety of alternative roboticstructures, including those described in U.S. Pat. No. 5,878,193, thefull disclosure of which is incorporated herein by reference.Additionally, while the data communication between a robotic componentand the processor of the robotic surgical system is primarily describedherein with reference to communication between the surgical instrument522 and the controller, it should be understood that similarcommunication may take place between circuitry of a manipulator, aset-up joint, an endoscope or other image capture device, or the like,and the processor of the robotic surgical system for componentcompatibility verification, component-type identification, componentcalibration (such as off-set or the like) communication, confirmation ofcoupling of the component to the robotic surgical system, or the like.

FIG. 23 shows one example embodiment of a controller 518 that may beused in conjunction with a robotic arm cart, such as the robotic armcarts 520, 520′ depicted in FIGS. 20-22. The controller 518 generallyincludes master controllers (generally represented as 519 in FIG. 23)which are grasped by the clinician and manipulated in space while theclinician views the procedure via a stereo display 521. A surgeon feedback meter 515 may be viewed via the display 521 and provide the surgeonwith a visual indication of the amount of force being applied to thecutting instrument or dynamic clamping member. The master controllers519 generally comprise manual input devices which preferably move withmultiple degrees of freedom, and which often further have a handle ortrigger for actuating tools (for example, for closing grasping saws,applying an electrical potential to an electrode, or the like).

FIG. 24 shows one example embodiment of an ultrasonic surgicalinstrument 522 adapted for use with a robotic surgical system. Forexample, the surgical instrument 522 may be coupled to one of thesurgical manipulators 528, 528′ described hereinabove. As can be seen inFIG. 24, the surgical instrument 522 comprises a surgical end effector548 that comprises an ultrasonic blade 550 and clamp arm 552, which maybe coupled to an elongated shaft assembly 554 that, in some embodiments,may comprise an articulation joint 556. FIG. 25 shows another exampleembodiment having an electrosurgical instrument 523 in place of theultrasonic surgical instrument 522. The surgical instrument 523comprises a surgical end effector 548 that comprises closable jaws 551A,551B having energy deliver surfaces 553A, 553B for engaging andproviding electrical energy to tissue between the jaws 551A, 551B. Atissue cutting element or knife 555 may be positioned at the distal endof an axially movable member 557 that may extend through the elongatedshaft assembly 554 to the instrument mounting portion 558. FIG. 26 showsone embodiment of an instrument drive assembly 546 that may be coupledto one of the surgical manipulators 528, 528′ to receive and control thesurgical instruments 522, 523. The instrument drive assembly 546 mayalso be operatively coupled to the controller 518 to receive inputs fromthe clinician for controlling the instrument 522, 523. For example,actuation (e.g., opening and closing) of the clamp arm 552, actuation(e.g., opening and closing) of the jaws 551A, 551B, actuation of theultrasonic blade 550, extension of the knife 555 and actuation of theenergy delivery surfaces 553A, 553B, etc. may be controlled through theinstrument drive assembly 546 based on inputs from the clinicianprovided through the controller 518. The surgical instrument 522 isoperably coupled to the manipulator by an instrument mounting portion,generally designated as 558. The surgical instruments 522 furtherinclude an interface 560 which mechanically and electrically couples theinstrument mounting portion 558 to the manipulator.

FIG. 27 shows another view of the instrument drive assembly of FIG. 26including the ultrasonic surgical instrument 522. FIG. 28 shows anotherview of the instrument drive assembly of FIG. 26 including theelectrosurgical instrument 523. The instrument mounting portion 558includes a tool mounting plate 562 that operably supports a plurality of(four are shown in FIG. 26) rotatable body portions, driven discs orelements 564, that each include a pair of pins 566 that extend from asurface of the driven element 564. One pin 566 is closer to an axis ofrotation of each driven elements 564 than the other pin 566 on the samedriven element 564, which helps to ensure positive angular alignment ofthe driven element 564. The driven elements 564 and pints 566 may bepositioned on an adapter side 567 of the instrument mounting plate 562.

Interface 560 also includes an adaptor portion 568 that is configured tomountingly engage the mounting plate 562 as will be further discussedbelow. The adaptor portion 568 may include an array of electricalconnecting pins 570, which may be coupled to a memory structure by acircuit board within the instrument mounting portion 558. Whileinterface 560 is described herein with reference to mechanical,electrical, and magnetic coupling elements, it should be understood thata wide variety of telemetry modalities might be used, includinginfrared, inductive coupling, or the like.

FIGS. 29-31 show additional views of the adapter portion 568 of theinstrument drive assembly 546 of FIG. 26. The adapter portion 568generally includes an instrument side 572 and a holder side 574 (FIG.29). In various embodiments, a plurality of rotatable bodies 576 aremounted to a floating plate 578 which has a limited range of movementrelative to the surrounding adaptor structure normal to the majorsurfaces of the adaptor 568. Axial movement of the floating plate 578helps decouple the rotatable bodies 576 from the instrument mountingportion 558 when the levers 580 along the sides of the instrumentmounting portion housing 582 are actuated (See FIGS. 24, 25) Othermechanisms/arrangements may be employed for releasably coupling theinstrument mounting portion 558 to the adaptor 568. In at least oneform, rotatable bodies 576 are resiliently mounted to floating plate 578by resilient radial members which extend into a circumferentialindentation about the rotatable bodies 576. The rotatable bodies 576 canmove axially relative to plate 578 by deflection of these resilientstructures. When disposed in a first axial position (toward instrumentside 572) the rotatable bodies 576 are free to rotate without angularlimitation. However, as the rotatable bodies 576 move axially towardinstrument side 572, tabs 584 (extending radially from the rotatablebodies 576) laterally engage detents on the floating plates so as tolimit angular rotation of the rotatable bodies 576 about their axes.This limited rotation can be used to help drivingly engage the rotatablebodies 576 with drive pins 586 of a corresponding instrument holderportion 588 of the robotic system, as the drive pins 586 will push therotatable bodies 576 into the limited rotation position until the pins586 are aligned with (and slide into) openings 590.

Openings 590 on the instrument side 572 and openings 590 on the holderside 574 of rotatable bodies 576 are configured to accurately align thedriven elements 564 (FIGS. 27, 28) of the instrument mounting portion558 with the drive elements 592 of the instrument holder 588. Asdescribed above regarding inner and outer pins 566 of driven elements564, the openings 590 are at differing distances from the axis ofrotation on their respective rotatable bodies 576 so as to ensure thatthe alignment is not 33 degrees from its intended position.Additionally, each of the openings 590 may be slightly radiallyelongated so as to fittingly receive the pins 566 in the circumferentialorientation. This allows the pins 566 to slide radially within theopenings 590 and accommodate some axial misalignment between theinstrument 522, 523 and instrument holder 588, while minimizing anyangular misalignment and backlash between the drive and driven elements.Openings 590 on the instrument side 572 may be offset by about 90degrees from the openings 590 (shown in broken lines) on the holder side574, as can be seen most clearly in FIG. 31.

Various embodiments may further include an array of electrical connectorpins 570 located on holder side 574 of adaptor 568, and the instrumentside 572 of the adaptor 568 may include slots 594 (FIG. 31) forreceiving a pin array (not shown) from the instrument mounting portion558. In addition to transmitting electrical signals between the surgicalinstrument 522, 523 and the instrument holder 588, at least some ofthese electrical connections may be coupled to an adaptor memory device596 (FIG. 30) by a circuit board of the adaptor 568.

A detachable latch arrangement 598 may be employed to releasably affixthe adaptor 568 to the instrument holder 588. As used herein, the term“instrument drive assembly” when used in the context of the roboticsystem, at least encompasses various embodiments of the adapter 568 andinstrument holder 588 and which has been generally designated as 546 inFIG. 26. For example, as can be seen in FIG. 26, the instrument holder588 may include a first latch pin arrangement 600 that is sized to bereceived in corresponding clevis slots 602 provided in the adaptor 568.In addition, the instrument holder 588 may further have second latchpins 604 that are sized to be retained in corresponding latch clevises606 in the adaptor 568. See FIG. 30. In at least one form, a latchassembly 608 is movably supported on the adapter 568 and is biasablebetween a first latched position wherein the latch pins 600 are retainedwithin their respective latch clevis 602 and an unlatched positionwherein the second latch pins 604 may be into or removed from the latchclevises 606. A spring or springs (not shown) are employed to bias thelatch assembly into the latched position. A lip on the instrument side572 of adaptor 568 may slidably receive laterally extending tabs ofinstrument mounting housing 582.

As described the driven elements 564 may be aligned with the driveelements 592 of the instrument holder 588 such that rotational motion ofthe drive elements 592 causes corresponding rotational motion of thedriven elements 564. The rotation of the drive elements 592 and drivenelements 564 may be electronically controlled, for example, via therobotic arm 512, in response to instructions received from the clinician502 via a controller 508. The instrument mounting portion 558 maytranslate rotation of the driven elements 564 into motion of thesurgical instrument 522, 523.

FIGS. 32-34 show one example embodiment of the instrument mountingportion 558 showing components for translating motion of the drivenelements 564 into motion of the surgical instrument 522, 523. FIGS.32-34 show the instrument mounting portion with a shaft 538 having asurgical end effector 610 at a distal end thereof. The end effector 610may be any suitable type of end effector for performing a surgical taskon a patient. For example, the end effector may be configured to provideRF and/or ultrasonic energy to tissue at a surgical site. The shaft 538may be rotatably coupled to the instrument mounting portion 558 andsecured by a top shaft holder 646 and a bottom shaft holder 648 at acoupler 650 of the shaft 538.

In one example embodiment, the instrument mounting portion 558 comprisesa mechanism for translating rotation of the various driven elements 564into rotation of the shaft 538, differential translation of membersalong the axis of the shaft (e.g., for articulation), and reciprocatingtranslation of one or more members along the axis of the shaft 538(e.g., for extending and retracting tissue cutting elements such as 555,overtubes and/or other components). In one example embodiment, therotatable bodies 612 (e.g., rotatable spools) are coupled to the drivenelements 564. The rotatable bodies 612 may be formed integrally with thedriven elements 564. In some embodiments, the rotatable bodies 612 maybe formed separately from the driven elements 564 provided that therotatable bodies 612 and the driven elements 564 are fixedly coupledsuch that driving the driven elements 564 causes rotation of therotatable bodies 612. Each of the rotatable bodies 612 is coupled to agear train or gear mechanism to provide shaft articulation and rotationand clamp jaw open/close and knife actuation.

In one example embodiment, the instrument mounting portion 558 comprisesa mechanism for causing differential translation of two or more membersalong the axis of the shaft 538. In the example provided in FIGS. 32-34,this motion is used to manipulate articulation joint 556. In theillustrated embodiment, for example, the instrument mounting portion 558comprises a rack and pinion gearing mechanism to provide thedifferential translation and thus the shaft articulation functionality.In one example embodiment, the rack and pinion gearing mechanismcomprises a first pinion gear 614 coupled to a rotatable body 612 suchthat rotation of the corresponding driven element 564 causes the firstpinion gear 614 to rotate. A bearing 616 is coupled to the rotatablebody 612 and is provided between the driven element 564 and the firstpinion gear 614. The first pinion gear 614 is meshed to a first rackgear 618 to convert the rotational motion of the first pinion gear 614into linear motion of the first rack gear 618 to control thearticulation of the articulation section 556 of the shaft assembly 538in a left direction 620L. The first rack gear 618 is attached to a firstarticulation band 622 (FIG. 32) such that linear motion of the firstrack gear 618 in a distal direction causes the articulation section 556of the shaft assembly 538 to articulate in the left direction 620L. Asecond pinion gear 626 is coupled to another rotatable body 612 suchthat rotation of the corresponding driven element 564 causes the secondpinion gear 626 to rotate. A bearing 616 is coupled to the rotatablebody 612 and is provided between the driven element 564 and the secondpinion gear 626. The second pinion gear 626 is meshed to a second rackgear 628 to convert the rotational motion of the second pinion gear 626into linear motion of the second rack gear 628 to control thearticulation of the articulation section 556 in a right direction 620R.The second rack gear 628 is attached to a second articulation band 624(FIG. 33) such that linear motion of the second rack gear 628 in adistal direction causes the articulation section 556 of the shaftassembly 538 to articulate in the right direction 620R. Additionalbearings may be provided between the rotatable bodies and thecorresponding gears. Any suitable bearings may be provided to supportand stabilize the mounting and reduce rotary friction of shaft andgears, for example.

In one example embodiment, the instrument mounting portion 558 furthercomprises a mechanism for translating rotation of the driven elements564 into rotational motion about the axis of the shaft 538. For example,the rotational motion may be rotation of the shaft 538 itself. In theillustrated embodiment, a first spiral worm gear 630 coupled to arotatable body 612 and a second spiral worm gear 632 coupled to theshaft assembly 538. A bearing 616 (FIG. 17) is coupled to a rotatablebody 612 and is provided between a driven element 564 and the firstspiral worm gear 630. The first spiral worm gear 630 is meshed to thesecond spiral worm gear 632, which may be coupled to the shaft assembly538 and/or to another component of the instrument 522, 523 for whichlongitudinal rotation is desired. Rotation may be caused in a clockwise(CW) and counter-clockwise (CCW) direction based on the rotationaldirection of the first and second spiral worm gears 630, 632.Accordingly, rotation of the first spiral worm gear 630 about a firstaxis is converted to rotation of the second spiral worm gear 632 about asecond axis, which is orthogonal to the first axis. As shown in FIGS.32-33, for example, a CW rotation of the second spiral worm gear 632results in a CW rotation of the shaft assembly 538 in the directionindicated by 634CW. A CCW rotation of the second spiral worm gear 632results in a CCW rotation of the shaft assembly 538 in the directionindicated by 634CCW. Additional bearings may be provided between therotatable bodies and the corresponding gears. Any suitable bearings maybe provided to support and stabilize the mounting and reduce rotaryfriction of shaft and gears, for example.

In one example embodiment, the instrument mounting portion 558 comprisesa mechanism for generating reciprocating translation of one or moremembers along the axis of the shaft 538. Such translation may be used,for example to drive a tissue cutting element, such as 555, drive anovertube for closure and/or articulation of the end effector 610, etc.In the illustrated embodiment, for example, a rack and pinion gearingmechanism may provide the reciprocating translation. A first gear 636 iscoupled to a rotatable body 612 such that rotation of the correspondingdriven element 564 causes the first gear 636 to rotate in a firstdirection. A second gear 638 is free to rotate about a post 640 formedin the instrument mounting plate 562. The first gear 636 is meshed tothe second gear 638 such that the second gear 638 rotates in a directionthat is opposite of the first gear 636. In one example embodiment, thesecond gear 638 is a pinion gear meshed to a rack gear 642, which movesin a liner direction. The rack gear 642 is coupled to a translatingblock 644, which may translate distally and proximally with the rackgear 642. The translation block 644 may be coupled to any suitablecomponent of the shaft assembly 538 and/or the end effector 610 so as toprovide reciprocating longitudinal motion. For example, the translationblock 644 may be mechanically coupled to the tissue cutting element 555of the RF surgical device 523. In some embodiments, the translationblock 644 may be coupled to an overtube, or other component of the endeffector 610 or shaft 538.

FIGS. 35-37 illustrate an alternate embodiment of the instrumentmounting portion 558 showing an alternate example mechanism fortranslating rotation of the driven elements 564 into rotational motionabout the axis of the shaft 538 and an alternate example mechanism forgenerating reciprocating translation of one or more members along theaxis of the shaft 538. Referring now to the alternate rotationalmechanism, a first spiral worm gear 652 is coupled to a second spiralworm gear 654, which is coupled to a third spiral worm gear 656. Such anarrangement may be provided for various reasons including maintainingcompatibility with existing robotic systems 500 and/or where space maybe limited. The first spiral worm gear 652 is coupled to a rotatablebody 612. The third spiral worm gear 656 is meshed with a fourth spiralworm gear 658 coupled to the shaft assembly 538. A bearing 760 iscoupled to a rotatable body 612 and is provided between a driven element564 and the first spiral worm gear 738. Another bearing 760 is coupledto a rotatable body 612 and is provided between a driven element 564 andthe third spiral worm gear 652. The third spiral worm gear 652 is meshedto the fourth spiral worm gear 658, which may be coupled to the shaftassembly 538 and/or to another component of the instrument 522, 523 forwhich longitudinal rotation is desired. Rotation may be caused in a CWand a CCW direction based on the rotational direction of the spiral wormgears 656, 658. Accordingly, rotation of the third spiral worm gear 656about a first axis is converted to rotation of the fourth spiral wormgear 658 about a second axis, which is orthogonal to the first axis. Asshown in FIGS. 36 and 37, for example, the fourth spiral worm gear 658is coupled to the shaft 538, and a CW rotation of the fourth spiral wormgear 658 results in a CW rotation of the shaft assembly 538 in thedirection indicated by 634CW. A CCW rotation of the fourth spiral wormgear 658 results in a CCW rotation of the shaft assembly 538 in thedirection indicated by 634CCW. Additional bearings may be providedbetween the rotatable bodies and the corresponding gears. Any suitablebearings may be provided to support and stabilize the mounting andreduce rotary friction of shaft and gears, for example.

Referring now to the alternate example mechanism for generatingreciprocating translation of one or more members along the axis of theshaft 538, the tool mounting portion 558 comprises a rack and piniongearing mechanism to provide reciprocating translation along the axis ofthe shaft 538 (e.g., translation of a tissue cutting element 555 of theRF surgical device 523). In one example embodiment, a third pinion gear660 is coupled to a rotatable body 612 such that rotation of thecorresponding driven element 564 causes the third pinion gear 660 torotate in a first direction. The third pinion gear 660 is meshed to arack gear 662, which moves in a linear direction. The rack gear 662 iscoupled to a translating block 664. The translating block 664 may becoupled to a component of the device 522, 523, such as, for example, thetissue cutting element 555 of the RF surgical device and/or an overtubeor other component which is desired to be translated longitudinally.

FIGS. 38-42 illustrate an alternate embodiment of the instrumentmounting portion 558 showing another alternate example mechanism fortranslating rotation of the driven elements 564 into rotational motionabout the axis of the shaft 538. In FIGS. 38-42, the shaft 538 iscoupled to the remainder of the mounting portion 558 via a coupler 676and a bushing 678. A first gear 666 coupled to a rotatable body 612, afixed post 668 comprising first and second openings 672, first andsecond rotatable pins 674 coupled to the shaft assembly, and a cable 670(or rope). The cable is wrapped around the rotatable body 612. One endof the cable 670 is located through a top opening 672 of the fixed post668 and fixedly coupled to a top rotatable pin 674. Another end of thecable 670 is located through a bottom opening 672 of the fixed post 668and fixedly coupled to a bottom rotating pin 674. Such an arrangement isprovided for various reasons including maintaining compatibility withexisting robotic systems 500 and/or where space may be limited.Accordingly, rotation of the rotatable body 612 causes the rotationabout the shaft assembly 538 in a CW and a CCW direction based on therotational direction of the rotatable body 612 (e.g., rotation of theshaft 538 itself). Accordingly, rotation of the rotatable body 612 abouta first axis is converted to rotation of the shaft assembly 538 about asecond axis, which is orthogonal to the first axis. As shown in FIGS.38-39, for example, a CW rotation of the rotatable body 612 results in aCW rotation of the shaft assembly 538 in the direction indicated by634CW. A CCW rotation of the rotatable body 612 results in a CCWrotation of the shaft assembly 538 in the direction indicated by 634CCW.Additional bearings may be provided between the rotatable bodies and thecorresponding gears. Any suitable bearings may be provided to supportand stabilize the mounting and reduce rotary friction of shaft andgears, for example.

FIGS. 43-46A illustrate an alternate embodiment of the instrumentmounting portion 558 showing an alternate example mechanism fordifferential translation of members along the axis of the shaft 538(e.g., for articulation). For example, as illustrated in FIGS. 43-46A,the instrument mounting portion 558 comprises a double cam mechanism 680to provide the shaft articulation functionality. In one exampleembodiment, the double cam mechanism 680 comprises first and second camportions 680A, 680B. First and second follower arms 682, 684 arepivotally coupled to corresponding pivot spools 686. As the rotatablebody 612 coupled to the double cam mechanism 680 rotates, the first camportion 680A acts on the first follower arm 682 and the second camportion 680B acts on the second follower arm 684. As the cam mechanism680 rotates the follower arms 682, 684 pivot about the pivot spools 686.The first follower arm 682 may be attached to a first member that is tobe differentially translated (e.g., the first articulation band 622).The second follower arm 684 is attached to a second member that is to bedifferentially translated (e.g., the second articulation band 624). Asthe top cam portion 680A acts on the first follower arm 682, the firstand second members are differentially translated. In the exampleembodiment where the first and second members are the respectivearticulation bands 622 and 624, the shaft assembly 538 articulates in aleft direction 620L. As the bottom cam portion 680B acts of the secondfollower arm 684, the shaft assembly 538 articulates in a rightdirection 620R. In some example embodiments, two separate bushings 688,690 are mounted beneath the respective first and second follower arms682, 684 to allow the rotation of the shaft without affecting thearticulating positions of the first and second follower arms 682, 684.For articulation motion, these bushings reciprocate with the first andsecond follower arms 682, 684 without affecting the rotary position ofthe jaw 902. FIG. 46A shows the bushings 688, 690 and the dual camassembly 680, including the first and second cam portions 680B, 680B,with the first and second follower arms 682, 684 removed to provide amore detailed and clearer view.

As illustrated in FIGS. 46B-46C, the instrument mounting portion 558′may comprise a distal portion 702. The distal portion 702 may comprisevarious mechanisms for coupling rotation of drive elements 592 to endeffectors of the various surgical instruments 522, 523, for example, asdescribed herein above. Proximal of the distal portion 702, theinstrument mounting portion 558′ comprises an internal direct current(DC) energy source and an internal drive and control circuit 704. In theillustrated embodiment, the energy source comprises a first and secondbattery 706, 708. In other respects, the instrument mounting portion558′ is similar to the various embodiments of the instrument mountingportion 558 described herein above.

The control circuit 704 may operate in a manner similar to thatdescribed above with respect to generators 20, 320. For example, when anultrasonic instrument 522 is utilized, the control circuit 704 mayprovide an ultrasonic drive signal in a manner similar to that describedabove with respect to generator 20. Also, for example, when an RFinstrument 523 or ultrasonic instrument 522 capable of providing atherapeutic or non-therapeutic RF signal is used, the control circuit704 may provide an RF drive signal, for example, as described hereinabove with respect to the module 23 of generator 20 and/or the generator300. In some embodiments, the control circuit 704 may be configured in amanner similar to that of the control circuit 440 described herein abovewith respect to FIGS. 18B-18C.

Various embodiments of a control system for controlling the roboticsurgical system 500 are discussed below. It will be appreciated by thoseskilled in the art that the terms “proximal” and distal,” as used inreference to the control system, are defined relative to a cliniciangripping the handpiece of the control system. Thus, movement in thedistal direction would be movement in a direction away from theclinician. It will be further appreciated that, for convenience andclarity, special terms such as “top” and “bottom” are also used hereinwith respect to the clinician gripping the handpiece assembly. However,the control system may be used in many orientations and positions, andthese terms are not intended to be limiting or absolute.

The various embodiments will be described in combination with therobotic surgical system 500 described above. Such description isprovided by way of example and not limitation, and is not intended tolimit the scope and applications thereof. For example, as will beappreciated by one skilled in the art, any one of the described controlsystems may be useful in combination with a multitude of roboticsurgical systems.

FIG. 47 illustrates one embodiment of a surgical robot control system700 in block form. FIGS. 48-50 show one embodiment of surgical robotcontrol system 700 with simplified components. The surgical robotcontrol system 700 may be used in conjunction with various roboticsurgical systems, such as, for example, the robotic surgical system 500described above. In the embodiment shown in FIG. 47, the surgical robotcontrol system 700 may comprise a controller 724 coupled to a handheldsurgical user interface 726. The handheld surgical user interface 726may be coupled to the controller 724 by any suitable coupling system,such as, for example, mechanical coupling, electrical coupling, opticalcoupling, or any combination thereof. The controller 724 is in signalcommunication with a robotic surgical system 722. Signal communicationbetween the controller 724 and the robotic surgical system 722 may beaccomplished using a variety of mediums and protocols, including, butnot limited to, direct wire communication, direct wirelesscommunication, communication over a LAN, WAN, wireless LAN or any othersuitable communication system. The robotic surgical system 722 may beany suitable robotic surgical system, including, but not limited to,those described herein. The robotic surgical system 722 comprises an armcart 710 mechanically and electrically coupled to the robotic surgicalsystem.

In one example embodiment, a user may manipulate the handheld surgicaluser interface 726 to control the robotic surgical system 722 and thearm cart 710. In various embodiments, at least one sensor 712 detectsone or more movements of the handheld surgical user interface 726. Thesensor 712 communicates these movements to the controller 724. In someembodiments, the at least one sensor 712 may convert the movementsdirectly into control signals for the robotic surgical system. Inanother embodiment, the at least one sensor 712 may communicate themovements directly to the controller 724 which converts the movement ofthe handheld surgical user interface 726 into electrical control signalsfor the robotic surgical system 722 and the arm cart 710.

The robotic surgical system 722 receives control signals from thecontroller 724. The control signals may, in various embodiments, controlthe robotic surgical system 722 and the arm cart 710 to cause movementof one or more portions of the robotic surgical system 722. Thesemovements may include, without limitation, distal or proximaltranslation of an end effector or robotic manipulator, left or righttranslation of an end effector or robotic manipulator, up or downtranslation of an end effector or robotic manipulator, rotation of anend effector or robotic manipulator, articulation of an end effector orrobotic manipulator, and application of various forms of energy, suchas, for example, ultrasonic or electrosurgical energy.

The handheld surgical user interface 726 may, in various embodiments, beany shape suitable to provide an easily manipulatable handle for a user.In some embodiments, the handheld surgical user interface 726 may be ajoystick. In other embodiments, the handheld surgical user interface 726may be a surgical device handle, similar to those described in relationto FIGS. 1-18. The handheld surgical user interface 726 provides theadvantage of allowing a surgeon to operate a robotic surgical systemwith minimum training. In some embodiments, the handheld surgical userinterface 726 provides the advantage of maintaining a user's skill instandard non-robotic surgery by simulating the movements and proceduresthat would be used in a non-robotic surgery during robotic surgery,allowing a surgeon to seamlessly move between robotic surgical systemsand non-robotic surgery with no loss of dexterity or skill.

In some embodiments, the handheld surgical user interface may compriseone or more switches. The one or more switches may be configurable tocontrol one or more functions of the end effector of the surgicalinstrument. For example, a first switch may be configured to control theapplication of electrosurgical energy to the end effector 523. Inanother embodiment, a second switch may be configured to controlactuation of the first and second jaw members 551A,B of the end effector523. It will be appreciated by those skilled in the art that anysuitable switch may be incorporated into the handheld surgical userinterface 726 to provide control of one or more functions of thesurgical instrument.

In one example embodiment, the surgical robot control system 700 maycomprise at least one feedback device 714. The at least one feedbackdevice 714 may coupled to the controller 724, to the socket 716, orboth. The at least one feedback device provides a signal to the userthat corresponds to one or more predetermined conditions of the roboticsurgical system 722. Some or all of the predetermined conditions may berelated to the status of energy delivery. For example, feedback may beprovided to indicate that energy deliver is on; energy delivery is off;energy delivery is completed. Some or all of the predeterminedconditions may also related to a temperature of the end effector and/orblade including. Examples of such predetermined conditions may includethat the temperature is high; that the temperature is safe; and/or anindication of actual temperature. Some or all of the predeterminedconditions may also relate to the force exerted on the end effector,either by closing or firing. These conditions may related to thethickness of tissue being treated and/or obstructions.

The feedback device 714 may provide any suitable form of sensoryfeedback corresponding to the predetermined instrument conditions.Examples of suitable sensory feedback may include auditory feedback(sound), haptic or tactile feedback (touch), optical feedback (visual orgraphic), olfactory feedback (smell), gustatory feedback (taste), and/orequilibrioception (balance feedback). Haptic feedback may be providedthrough various forms, for example, mechanosensation, including, but notlimited to, vibrosensation (vibrations) and pressure-sensation,thermoperception (heat), and/or cryoperception (cold). It will beappreciated by those skilled in the art that any single feedback type,or any combination thereof, may be used to provide a user with feedbackfrom the robotic surgical system 722. In some embodiments, properties ofthe feedback may provide a quantitative indication of the predeterminedconditions. For example, a quantitative indication of a temperature ofthe end effector may be provided by an audio tone having a pitch thatvaries with temperature, a series of pulses having a pulse frequencythat varies with temperature, etc.

The feedback device 714 may be located in any suitable location toprovide appropriate feedback to the user. In one example embodiment, thefeedback device 714 is located within the housing 728 of the surgicalrobot control system 700. In another embodiment, the feedback device 714may be located within the handheld surgical user interface 726. This isshown in FIGS. 48-50, in which the feedback device 714 is shown inphantom in both the housing 728 and the handheld surgical user interface726. In yet another embodiment, the feedback device may be locatedwithin some other portion of the robotic surgical control system, suchas, for example, the stereo display 521 (see FIG. 23) or may be aseparate unit which interfaces with the controller 724 through a secondsocket (not shown) mounted on the housing 728.

In various embodiments, the handheld surgical user interface 726connects to the controller 722 and the at least one sensor 712 through asocket 716 (see FIG. 49.) In various embodiments, the socket 716 may bemounted on outer surface of the housing 728. In other embodiments, thesocket 716 may be recessed in the housing 728. In one exampleembodiment, the socket 716 and the at least one sensor 712 may comprisea single device, such as, for example, a six-degrees of movement inputdevice capable of receiving the handheld surgical user interface 726.

As shown in FIGS. 48-50, the socket 716 and the at least one sensor 712may allow the handheld surgical user interface 726 to be manipulated inmultiple degrees of movement. The socket 716 and the sensor 712 mayallow the handheld surgical user interface 726 to be manipulated in anynumber of degrees of movement from one degree of movement to six degreesof movement (or free movement). In a six-degrees of movement embodiment,the handheld surgical user interface 726 may be manipulated bytranslation in three perpendicular axes and rotation about threeperpendicular axes. The translation movement may be referred to as, forexample, movement along a distal/proximal axis, an up/down axis, or aleft/right axis. The rotational movement may be referred to, forexample, as pitch, yaw, or roll. One skilled in the art will recognizethat these terms are used only for illustration and are not meant to belimiting in any way.

In one example embodiment, the handheld surgical user interface 726 maybe configured to work with one or more specific surgical instrumentsattached to the robotic surgical system 722. For example the ultrasonicsurgical instrument 522, as described above, may be attached to therobotic surgical system to allow delivery of ultrasonic energy to atissue site. The handheld surgical user interface may provide specificcontrols for the ultrasonic surgical instrument, such as, for example, atrigger to activate a clamping motion of the ultrasonic surgicalinstrument or a switch to activate an ultrasonic generator to deliverultrasonic energy to the ultrasonic blade 550.

In one example embodiment, the surgical robot control system 700 maycomprise a surgical instrument compatibility logic 715. The surgicalinstrument compatibility logic 715 may be configured to provide a signalindicating whether the surgical instrument connected to the arm cart 520is compatible with the handheld surgical user interface 726 connected tothe surgical robot control system 700. By checking to ensurecompatibility between the surgical instrument and the handheld surgicaluser interface 726, the surgical instrument compatibility logic 715 mayprevent accidental actuation of the surgical instrument and ensure allfunctions of the surgical instrument are accessible by a user.

In one example embodiment, the surgical instrument compatibility logic715 may check compatibility between the surgical instrument and thehandheld surgical user interface 726 by receiving a unique identifiercode from the surgical instrument and comparing this to an identifiercode received from the handheld surgical user interface 726. If theidentifier codes match a compatibility signal may be provided to thecontroller 724 to allow translation of signals received by thecontroller 724 into control signals for the robotic surgical system 722.For example, if the ultrasonic surgical instrument 522 is attached tothe arm cart 520, a unique code may be sent to the surgical instrumentcompatibility logic 715 identifying the ultrasonic surgical instrument522. In another embodiment, the surgical instrument compatibility logic715 may check compatibility between the surgical instrument and thehandheld surgical user interface 726 by comparing the inputs receivablefrom the handheld surgical user interface 726 to the control signalsreceivable by the surgical instrument. If the input signals match thecontrol signals, the surgical instrument compatibility logic may providethe compatibility signal to the controller 724. Those skilled in the artwill recognize that any suitable form of compatibility checking may beused by the surgical instrument compatibility logic to compare thesurgical instrument and the handheld surgical user interface 726 and isnot limited to only the methods described herein.

In one example embodiment, the surgical instrument compatibility logic715 may be executed by a software program running on the controller 724or any other suitable processor. In another embodiment, the surgicalinstrument compatibility logic 715 may be executed by one or more logicgates. The logic gates may be hardwired as part of the robotic surgicalcontrol system 700 or may be executed by a programmable logic device,such as, for example, a field-programmable gate array. In anotherembodiment, the surgical instrument compatibility logic 715 may beimplemented by one or more state machines. It will be appreciated bythose skilled in the art that any suitable hardware, software, orcombination thereof may be used to implement the surgical instrumentcompatibility logic 715.

In one example embodiment, the robotic surgical control system mayinclude one or more sensitivity knobs for adjusting the ratio betweenone or more movements of the handheld surgical user interface 726 andthe surgical instrument. In one example embodiment, a sensitivity knobmay be adjusted to change the movement ration between the handheldsurgical user interface 726 in a proximal or distal direction andmovement of the surgical instrument in a corresponding proximal ordistal direction. In another embodiment, the one or more sensitivityknobs may control the ration between feedback signal received by thecontroller from the end effector and the feedback device 714 to providefor varying levels of sensitivity in the feedback delivered to the user.

FIGS. 51-52 illustrate one embodiment of a robotic surgical controlsystem 800. The robotic surgical control system 800 comprises a handheldsurgical user interface 806. The handheld surgical user interfaceincludes a lever 822 which is interfaced with a one-degree of movementsocket 816. The one-degree of movement socket 816 allows the lever 822to pivot about a pivot point in a distal/proximal direction. In oneexample embodiment, movement of the lever 822 in a distal direction isconverted into movement of a surgical instrument or robotic manipulatorin a distal direction relative to the arm cart 520 and a proximalmovement of the lever 822 is converted into a movement of the surgicalinstrument or robotic manipulator in a proximal direction relative tothe arm cart 520 (see FIG. 22).

In the embodiment shown in FIGS. 51-52, the robotic surgical controlsystem 800 comprises a trigger 820 mounted on the lever 822. The trigger820 may be depressed by a user to activate a function of the surgicalinstrument attached to the arm cart 510, such as, for example, aclamping motion of the end effector 523. In the embodiment shown inFIGS. 51-52, the trigger 820 is in electrical communication with thecontroller 724 through the socket 816. In other embodiments, the trigger820 may be coupled to the controller 724 through a second socket (notshown) mounted to the housing 808.

The lever 822 may also comprise a switch for activating one or morefunctions of the surgical instrument attached to the robotic surgicalsystem 500. In the illustrated embodiment, the switch is a hat-switch818. In one example embodiment, the hat-switch 818 controls theapplication of one or more forms of energy to the end effector of thesurgical instrument 522. The hat-switch 818 may be configured to provideultrasonic energy, electrosurgical energy, or both to the end effector.The hat-switch 818 may interface to the controller 724 through thesocket 816 or through a second socket (not shown). In one exampleembodiment, the switch may comprise a foot pedal connected to thecontroller 724 through a second socket (not shown). The foot pedal maybe operated by a user to control the application of one or more forms ofenergy to the end effector of the surgical instrument 522. In anotherembodiment, the switch may be a resistive sleeve placed over the lever822. A user may apply pressure to the resistive sleeve by squeezing thelever 822. By applying pressure to the resistive sleeve, a user maycontrol the application of one or more functions of the surgicalinstrument 522, such as, for example, the application of one or moretypes of energy to the end effector.

FIG. 53 illustrates one embodiment of a robotic surgical control system900. The robotic surgical control system 900 comprises a two-degrees ofmovement socket 916 for interfacing the handheld electronic surgicalinstrument 806. The two-degrees of movement socket 916 allows the lever822 to be manipulated about a pivot point 930 in a distal/proximaldirection and in a left/right direction. Movement of the lever 822results in movement of the robotic surgical system 500 similar to thatdescribed above with reference to the robotic surgical control system800. Movement of the lever 822 in the left/right direction results inrotation of the arm cart 520 in a clockwise or counterclockwisedirection (see FIGS. 35-36). In the embodiment shown in FIG. 53, thetwo-degrees of movement socket 916 comprises a t-shape to allow movementin only the proximal/distal and left/right directions. In anotherembodiment, the two degrees of movement socket 916 may have a plateplaced over the socket 916 and attached to the housing 908 to restrictmovement of the lever 822 to only the proximal/distal or left/rightdirections.

FIG. 54 illustrates one embodiment of a robotic surgical control system1000 comprising an unrestricted two-degrees of movement socket 1016. Theunrestricted two-degrees of movement socket 1016 allows the lever-stylehandheld surgical user interface 1006 to be rotated about a pivot point1030 in a proximal/distal direction and a left/right direction. Theunrestricted two-degrees of movement socket 1016 allows simultaneousrotation in both the proximal/distal and left/right directions, allowingthe surgical instrument to be advanced or retracted and rotatedsimultaneously. By allowing the surgical instrument to be advanced androtated simultaneously, the unrestricted two-degrees of movement socket1016 may be advantageously used, for example, to assist in piercingtissue or organs. The lever-style handheld surgical user interface 1006comprises a hat-switch 1018 for activating a function of the surgicalinstrument. The hat-switch 1018 may be used to activate any suitablefunction of the surgical instrument, such as, for example, applicationof ultrasonic or electrosurgical energy.

FIGS. 55-56 illustrate one embodiment of a robot surgical control system1100 comprising an unrestricted four-degrees of movement socket 1116.The unrestricted four-degrees of movement socket 1116 allows the lever1122 to be rotated about a pivot point 1130 in a proximal/distaldirection and a left/right direction. The unrestricted four-degrees ofmovement socket 1116 further allows the lever 1122 to rotate about avertical axis ‘V.’ The handheld surgical user interface 1106 has afourth-degree of movement by allowing lateral movement along thevertical axis ‘V.’

The handheld surgical user interface 1106 comprises a shepherd's hooktrigger 1120 and hat-switch 1118. The shepherd's hook trigger 1120 andthe hat-switch 1118 may control one or more functions of the surgicalinstrument attached to the robotic surgical system. For example, theshepherd's hook trigger 1120 may control a clamping motion of the endeffector 523 and the hat-switch 1118 may control application of one ormore types of energy, such as electrosurgical energy, to the endeffector 523. Those skilled in the art will recognize that theshepherd's hook trigger 1120 and the hat-switch 1118 may be configuredto control any suitable function of the surgical instrument.

In one example embodiment, the housing 1108 of the robotic surgicalcontrol system 1100 has a visual feedback device 1114 mounted thereon.The visual feedback device 1114 may provide a visual signal to anoperator regarding one or more functions of the surgical instrument orthe robotic surgical control system 1100. In one example embodiment, thevisual feedback device 1114 comprises an LED lamp which is illuminatedin response to an application of energy to the end effector of thesurgical instrument, such as, for example, the end effector 548. Inanother embodiment, the visual feedback device 1114 may be activated tosignal the end of pre-programmed function of the surgical instrument,such as, for example, a computer-controlled cutting and sealingoperation. Those skilled in the art will recognize that visual feedbackdevice 1114 may be configured to display the status of any compatiblesurgical instrument function.

FIG. 57 illustrates one embodiment of a robotic surgical control system1200 which comprises a stand-alone input device 1201. The stand-aloneinput device 1201 includes the handheld surgical user interface 1206connected to a base 1208. The base 1208 contains a socket 1216, a sensor1212, and a cable 1222. The cable 1222 is connected to a second socket1116′ on the housing 1108. The second socket 1116′ allows thestand-alone input device 1201 to electrically couple to the controller724. The stand-alone input device 1201 provides the advantage ofallowing an input system to be designed for a specific surgicalinstrument while still interfacing through the same controller 724 usedby a handheld surgical user interface 1106 without having to be pluggeddirectly into the socket 1116 on the housing 1108. FIG. 57 furtherillustrates an embodiment in which multiple stand-alone input devices1201 or a stand-alone input device 1201 and a handheld surgical userinterface 726 may be utilized simultaneously, by interfacing withmultiple sockets 1116, 1116′ located on the housing 1108. Thestand-alone input device 1201 may contain one or more feedback devices1214, 1214′ located one the base 1208, within the handheld surgical userinterface 1206, or both. The robotic surgical control system 1200 mayalso utilize the feedback devices 714, 1114, located on the housing1108.

With reference now to FIGS. 55-60, various feedback devices suitable foruse with the handheld surgical user interface 726, 806, 1006, 1106, 1206shall now be described. FIGS. 55-57 illustrate the use of at least onefeedback device 714 located within the lever-style handheld surgicaluser interfaces 1106, 1206. In one example embodiment, the at least onefeedback device 714 may comprise vibratory modules 1114′, 1214′ toprovide vibratory motion to the lever-style handheld surgical userinterfaces 1106, 1206. The vibratory module 1114′, 1214′ may receive afeedback signal from the surgical instrument indicative of a forceapplied to the surgical instrument by interaction with a tissue site. Inone example embodiment, the vibratory module 1114′, 1214′ may generatevibratory movement proportional to the total amount of force applied tothe surgical instrument by the tissue site. In other embodiments, thevibratory module 1114′, 1214′ may generate vibratory movementproportional to the amount of force applied to the surgical instrumentin a single direction or plain by the tissue site. In anotherembodiment, the vibratory module 1114′, 1214′ may be configured togenerate vibratory motion proportional to the amount of energy deliveredto an end effector, such as, for example, electrosurgical energydelivered to end effector 548. In yet another embodiment, the vibratorymodule 1114′, 1214′ may be configured to generate vibratory motion aftera preprogrammed function has been performed, such as, for example, anautomatic sealing and cutting algorithm for the end effector 548. Thevibratory motion generated by the vibratory module 1114′, 1214′ may beadjusted to provide varying levels of sensitivity to the user.

In some embodiments, the one or more feedback devices 714 may providehaptic feedback through one or more force feedback devices 1214″. Forcefeedback provides a force or motion in a specific direction to resistmovement of the handheld surgical user interface in an oppositedirection. In one example embodiment, the one or more force feedbackdevices 1214″ may comprise any suitable device, such as, for example, aservo motor, a solenoid, or a variable pressure switch. In one exampleembodiment, the force applied by the one or more force feedback devices1214″ may be proportional to the total force encountered by the surgicalinstrument when interacting with a tissue site. In other embodiments,the one or more force feedback devices 1214″ may provide a forceproportional to a specific interaction between an end effector and atissue site. For example, In one example embodiment, a force feedbackdevice 1214″ may provide a resistive force to the movement of theshepherd's hook trigger 1120 which is proportional to a forceencountered by the jaws 551A,B of the end effector 548 during a tissueclamping operation.

FIGS. 58-60 illustrate one embodiment of the at least one feedbackdevice 714 comprising a thermal element 1314. As shown in FIG. 58, thethermal element 1314 may comprise a thermal sleeve configured to beplaced over the lever 1022 of the handheld surgical user interface 1006.The thermal element 1314 comprises a cable 1315 for interfacing thethermal element 1314 with a second socket 1016′ located on the housing1008. FIGS. 59-60 illustrate the thermal element 1314 being placed overthe lever 1022. Once the thermal element 1314 has been properly placedand interfaced with the controller 724 through the second socket 1016′,the thermal element may provide tactile feedback to the user in the formof a temperature gradient. In one example embodiment, the temperaturegradient may comprise heating the thermal element 1314 proportional to alevel of energy delivered to a tissue site by an end effector attachedto the surgical instrument, such as, for example, the end effector 548.By heating at a proportional rate to the energy delivered to the tissuesite, the thermal element 1314 provides a user with a tactile indicationof when a sufficient level of energy has been applied to the tissuesite. In another embodiment, the thermal element 1314 may deliver atemperature gradient indicative of a warning or overheating state toalert the user to unsafe conditions. It will be appreciated by thoseskilled in the art that the proportion between the temperature gradientand the energy deliver to the tissue site may be any proportion, butideally is calibrated to deliver adequate information to the userwithout causing discomfort or harm to the user.

In one example embodiment, the one or more feedback devices 714 mayprovide optical feedback to a user. Optical feedback may be provided byany visual indicator, such as, for example, LED lamps, gauges, scales,or any other visual indication. In one example embodiment, the opticalfeedback may be provided in response to the application of energy to anend effector, such as, for example, end effector 548.

In one example embodiment, the robotic surgical system 500 includes oneor more sensors for providing one or more feedback signals to thecontroller 724 for controlling the one or more feedback devices 714. Theone or more sensors attached to the robotic surgical system 500 may be asuitable sensor for providing a feedback signal, such as, for example, alinear position sensor, a rotational position sensor, a force sensor, athermal sensor, or any other sensor type. The one or more sensors may becombined integrally with the surgical instrument 522, 523 attached tothe robotic surgical system or may an additional module connected to thesurgical instrument 522, 523 to generate the necessary feedback signal.

FIG. 61 shows one embodiment of a robotic surgical control system 1300.The robotic surgical control system 1300 includes a handheld surgicaluser interface 1306. The handheld surgical user interface 1306 isconfigured to simulate the feel and operation of endoscopic,laparoscopic, or open surgical devices, such as, for example, thesurgical instruments shown in FIGS. 1-18. In one example embodiment, thehandheld surgical user interface comprises a surgical device handle1322, a shepherd's hook trigger 1320, a switch 1318, a rotation knob1326 and an interface shaft 1324. The interface shaft 1324 connects to asix-degrees of movement socket 1316 located on housing 1308. Thesix-degrees of movement socket 1316 allows the surgical device handle1322 to be freely manipulated by a user. The surgical device handle 1322may be advanced or retracted in a distal/proximal direction. In oneexample embodiment, movement of the surgical device handle 1322 in thedistal/proximal direction results in a corresponding movement of asurgical instrument in a distal/proximal direction in relation to thearm cart 520. The handheld surgical user interface 1306 may also bemoved through translation in left/right and up/down directions.Translation movement of the handheld surgical user interface 1306 in theleft/right or up/down directions may be converted into motion of thesurgical instrument in corresponding directions. The six-degrees ofmovement socket 1316 allows the surgical device handle 1322 to berotated about a pivot point 1317. The pivot point 1317, In one exampleembodiment, may correspond to the connection between the interface shaft1324 and the socket 1316. The handheld surgical user interface 1306 maybe rotated about any of the three axes of movement or any combinationthereof.

The six-degrees of movement socket 1316 and the surgical device handle1322 allow a user to operate the robotic surgical control system 1300 ina manner identical to the operation of a non-robotic surgicalinstrument, such as, for example, the surgical instruments shown inFIGS. 1-18. By simulating the movements of a non-robotic surgicalinstrument, the robotic surgical control system 1300 allows a surgeon tooperate a robotic surgical system, such as, for example, the roboticsurgical system 500 shown in FIGS. 19-46, with minimum training. Therobotic surgical control system 1300 also provides the advantage ofallowing a surgeon to maintain their skill in standard surgicalprocedures during the operation of a robotic surgical system.

In one example embodiment, the surgical device handle 1322 may compriseone or more additional inputs for controlling one or more functions of asurgical instrument. In the embodiment shown in FIG. 61, the surgicaldevice handle 1322 comprises a shepherd's hook trigger 1320, a switch1318, and a rotation knob 1326. The shepherd's hook trigger 1320 may beconfigured to control, for example, a clamping motion of an end effectorattached to the surgical instrument. By pulling the shepherd's hooktrigger 1320 towards the handle 1322, a user may cause the jaws of anend effector to pivot into a clamped position, such as, for example, thefirst and second jaws 551A,B of the end effector 548. Releasing theshepherd's hook trigger 1320 may, in one example embodiment, cause thejaws of the end effector to return to a non-clamped or open position.

In one example embodiment, the switch 1318 may control the applicationof one or more forms of energy to an end effector attached to thesurgical instrument 522. The switch 1318 may be configured to deliver,for example, ultrasonic energy to the ultrasonic surgical instrument 522or electrosurgical energy to the electrosurgical instrument 523. Inanother embodiment, the switch 1318 may be a multi-position switch whichmay comprise an off position, a first position configured to deliverultrasonic energy, a second position configured to deliverelectrosurgical energy, and a third position configured to deliver bothultrasonic and electrosurgical energy.

As shown in FIG. 61, the handheld surgical user interface 1306 maycomprise a rotation knob 1326 mounted to the surgical device handle 1322and operably coupled to the interface shaft 1324. The rotation knob 1326may be configured to allow rotation of the interface shaft 1324 aboutthe proximal/distal axis without rotation of the entire surgical devicehandle 1322. By rotating the rotation knob 1326, a user may cause anelongate shaft, such as for example the elongate shaft assembly 554 ofthe surgical instrument 522, to rotate while maintaining the sameorientation of the surgical device handle 1322. This motion simulatesthe use of a rotation knob on a non-robotic surgical instrument, suchas, for example, the surgical instruments shown in FIGS. 1-18.

In one example embodiment, the one or more additional inputs, such asthe shepherd's hook trigger 1320, the switch 1318, or the rotation knob1326, may be connected to the controller 724 by one or more wires (notshown) extending through the interface shaft 1324 and connecting throughthe six-degrees of movement socket 1316. In another embodiment, the oneor more additional inputs may be connected to the controller through awire which extends from the surgical device handle 1322 and connects tothe controller 724 through a second socket (not shown) located on thehousing 1308. In yet another embodiment, the one or more additionalinputs may communicate with the controller 724 through a wirelesscommunication link, such as, for example, a wireless Bluetooth link.Those skilled in the art will recognize that any suitable communicationprotocol or medium may be used to connect the one or more additionalinputs to the controller 724.

In one example embodiment, the robotic surgical control system 1300comprises one or more feedback devices 714. The one or more feedbackdevices 714 may be located in the housing 1308, the surgical devicehandle 1322, or both. The feedback device 714 may provide any suitableform of sensory feedback. Such sensory feedback may include, forexample, auditory feedback (sounds), haptic or tactile feedback (touch),optical feedback (visual), olfactory feedback (smell), gustatoryfeedback (taste), and/or equilibrioception (balance feedback). Hapticfeedback may be provided through various forms, for example,mechanosensation, including, but not limited to, vibrosensation(vibrations) and pressure-sensation, thermoperception (heat), and/orcryoperception (cold). It will be appreciated by those skilled in theart that any single feedback type, or any combination thereof, may beprovided by the one or more feedback devices 714.

FIG. 62 illustrates one embodiment of the robotic surgical controlsystem 1400. The robotic surgical control system 1400 comprises ahousing 1408 and a handheld surgical user interface 1406. The handheldsurgical user interface 1406 includes a surgical device handle 1422similar to the surgical device handle 1322 described above. The surgicaldevice handle 1422 includes a second rotation knob 1428 which may beconfigured to control one or more functions of the surgical instrument522, such as, for example, the angle of articulation of the elongateshaft assembly 554. In the illustrated embodiment, the surgical devicehandle 1422 includes the shepherd's hook trigger 1320, the button 1318,and the rotation knob 1326. In other embodiments, the surgical devicehandle 1400 may comprise some or none of the one or more additionalinputs.

In one example embodiment, the rotational inputs, such as, for example,the second rotation knob 1428, may comprise one or more detents to allowfor precise settings of various rotational positions. The detents maycorrespond to one or more ribs located on the surgical device handle1422 to allow the second rotation knob 1428 to assume precise rotationalpositions which correspond to one or more precise positions of thesurgical instrument 522. For example, in one example embodiment, thesecond rotation knob 1428 may control an articulation function of thesurgical instrument 522, such as, for example, articulation of theelongate shaft assembly 554. In this embodiment, the second rotationknob 1428 may comprise one or more detents which correspond to one ormore predetermined articulation positions of the elongate shaft assembly554.

In one example embodiment, the robotic surgical control system 1400comprises a three degrees of movement socket 1416. The three degrees ofmovement socket 1416 allows the surgical device handle 1422 to beconnected to the housing 1408 and the controller 724 through theinterface shaft 1324. The three degrees of movement socket 1416 allowsthe surgical device handle 1422 to be laterally advanced or retracted ina distal/proximal direction relative to the user of the device. Inaddition, the three-degrees of movement socket 1416 allows the surgicaldevice handle 1422 to be pivoted in an up/down and left/right directionabout a pivot point 1430 defined by the interface between the threedegrees of movement socket 1416 and the interface shaft 1324. Asdescribed above, a three degrees of movement input socket, such as thethree degrees of movement socket 1416, allows a user to control threemovements of a surgical instrument simultaneously. In one exampleembodiment, the three degrees of movement socket 1416 may be configuredto control lateral movement of a surgical instrument in adistal/proximal direction in response to lateral movement of thesurgical device handle 1422 in a distal or proximal direction.Rotational movement of the surgical device handle 1422 about the pivotpoint 1430 in the left or right direction may, In one exampleembodiment, be converted into later movement of the surgical instrument522 in a left/right direction in relation to the arm cart 520.Rotational movement of the surgical device handle 1422 about the pivotpoint 1430 in an up/down direction may result in lateral movement of thesurgical instrument 522 with respect to the arm cart 520.

FIG. 63 illustrates various feedback devices that may be used with thesurgical device handles 1322, 1422. In the illustrated embodiment, thesurgical device handle 1422 is illustrated with part of the outersurface removed and housing 1308 is shown with a side wall removed toillustrate the internal components therein. In one example embodiment,the housing 1308 may contain a feedback device coupled to thesix-degrees of movement socket 1316 to provide haptic feedback, in theform of force feedback, such as, for example, the electromagnetic clutch1438. In one example embodiment, the electromagnetic clutch 1438 may beconfigured to provide a resistive force to the movement of thesix-degrees of movement socket 1316. This resistive force is transferredthrough the interface shaft 1324 to the surgical device handle 1422. Auser moving the surgical device handle 1422 will sense the resistiveforce through the surgical device handle 1422. The resistive forcegenerated by the electromagnetic clutch 1438 maybe proportional to aresistive force encountered by a surgical instrument 522 in contact witha target tissue site. In one example embodiment, the resistive forcegenerated by the electromagnetic clutch 1438 is directly proportional tothe force encountered by a surgical instrument 522 in contact with atarget tissue site. In other embodiments, the force generated by theelectromagnetic clutch 1438 may be one or more orders of magnitudelarger, so as to provide greater feedback to the user. Theelectromagnetic clutch 1438 may provide resistive forces in any of theavailable degrees of movement. For example, in the illustratedembodiment, the electromagnetic clutch 1438 is coupled to thesix-degrees of movement socket 1316. The electromagnetic clutch mayprovide resistive force to movement of the six-degrees of movementsocket 1316 in any one of, or any combination of, the availablesix-degrees of movement.

In one example embodiment, one or more force feedback devices may belocated within the surgical device handle 1422. In the illustratedembodiment, two trigger feedback devices 1432 a,b are connected to theshepherd's hook trigger 1320. The trigger feedback devices 1432 a,bprovide haptic feedback in the form of a resistive force when pulling orreleasing the shepherd's hook trigger 1320. In one example embodiment,the trigger feedback devices 1432 a,b provide a resistive force to themovement of the shepherd's hook trigger 1320 that is proportional to aforce encountered by the jaws of an end effector connected to thesurgical instrument, such as, for example, the jaws 551A,B ofelectrosurgical end effector 548. For solely illustrative purposes, thetrigger feedback devices 1432 a,b shall be described in conjunction withend effector 548. In operation, a tissue portion is positioned betweenthe jaws 551A,B of the end effector 548. The shepherd's hook trigger1320 may be moved in a distal direction to cause the jaws 551A,B topivot from an open position to a closed position. As the jaws 551A,Bmove to a closed position, tissue located between the jaws 551A,Bprovides a resistive force to the closure of the jaws 551A,B. Thetrigger feedback devices 1432 a,b may provide resistance to the movementof the shepherd's hook trigger 1320 that is proportional to the forceencountered by the jaws 551A,B of the end effector 548. By providingfeedback to the shepherd's hook trigger 1320, the device provides anindication to a user regarding the tissue located between the jaws551A,B of the end effector 548, such as, for example, whether a properamount of tissue is located between the jaws 551A,B or what type oftissue is located between the jaws 551A,B.

As shown in FIG. 63, the surgical device handle 1422 may furthercomprise one or more rotational feedback devices. The rotation feedbackdevices, such as the articulation rotation feedback device 1430, mayprovide haptic feedback in the form of resistive force to rotation ofone or more inputs, such as, for example, the second rotation knob 1428.The resistive force provided by the articulation rotation feedbackdevice 1430, in one example embodiment, may be proportional to a forceapplied to an end effector in contact with a tissue site. In one exampleembodiment, a sensor may detect the force applied to an articulationjoint of the surgical instrument 522, such as, for example, articulationjoint 556. In one example embodiment, rotation of the second rotationknob 1428 may be converted by the controller 724 into control signalsthat cause the articulation joint 556 to articulate the shaft 554. Theend effector, such as, for example the end effector 548, may come intocontact with tissue as a result of the articulation movement. As the endeffector 548 comes into contact with tissue, a sensor on the surgicaldevice 523 may provide the controller 724 with a signal indicative ofthe amount of force applied to the end effector 548 by the tissue site(see FIG. 68). The controller 724 may cause the articulation rotationfeedback device 1430 to apply a resistive force to the rotation of thesecond rotation knob 1428 that is proportional to the force encounteredby the end effector 548.

As shown in FIG. 63, the surgical device handle 1422 may furthercomprise a vibratory module 1440 configured to provide vibratory motionto the surgical device handle 1422. In one example embodiment, thevibratory module 1440 may receive a feedback signal from a sensorcoupled to an end effector, such as, for example, end effector 528 (seeFIG. 68). When the end effector 528 comes into contact with tissue, aforce is exerted on the end effector 528 by the tissue. The feedbacksignal may, In one example embodiment, be indicative of the amount offorce encountered by the end effector 528. The vibratory module 1440 mayconvert the feedback signal into vibratory motion of the surgical devicehandle 1422 to provide a tactile feedback signal to the user which isproportional to the amount of force applied to the end effector 528 bythe tissue site. In one example embodiment, the vibratory module 1440may increase the rate of vibration exponentially as the feedback signalincreases to provide a user with a tactile warning of possible tissuedamage. In another embodiment, the vibratory module 1440 may beconfigured to receive a feedback signal from the end effector 528indicative of the amount of energy being applied to a tissue site by theend effector 528. In this embodiment, the vibratory module 1440 mayincrease the rate of vibration as the temperature of the tissue siteincreases in response to the application of energy. In anotherembodiment, vibratory module may activate to indicate to the user that apredetermined amount of time has passed, indicating sufficientapplication of energy to the tissue site.

In one example embodiment, the rotatable input devices, such as thefirst rotation knob 1326 and the second rotation knob 1428, may beconnected to a rotational encoder for converting the rotation of therotatable input devices into electrical signals for transmission to thecontroller 724. In the illustrated embodiment, rotation of the interfaceshaft 1324 via rotation of the first rotation knob 1326 is convertedinto an electrical signal by the rotational encoder 1436. The rotationalencoder 1436 converts the angular position or motion of the interfaceshaft 1324 to an analog or digital signal receivable by the controller724. The rotational encoder 1436 may be any suitable type of rotationalencoder, such as, for example, an absolute or incremental encoder. Inanother embodiment, the rotatable input devices may be connected to oneor more potentiometers, such as, for example, a rotary inputpotentiometer 1442. The rotary input potentiometer 1442 adjusts theoutput voltages based on the rotational position of shepherd's hooktrigger 1320, allowing the mechanical position of the shepherd's hooktrigger to be converted into a signal receivable by the controller 724.It will be appreciated by those skilled in the art that any suitableelectronic component for converting the mechanical rotation or movementof an input device may be used to generate a signal receivable by thecontroller 724.

FIGS. 64-65 illustrate two possible embodiments of the relationshipbetween the movement of the handheld surgical user interface 1406 andthe end effector 528. In one example embodiment, shown in FIG. 64,rotation of the handheld surgical user interface 1406 about a pivotpoint 1430 results in an articulating movement of end effector 528 inthe same direction, e.g., rotation of the handheld surgical userinterface 1406 in a right direction, shown as arrow ‘A’ results inmovement of the end effector 528 in the same, right direction. Inanother embodiment, shown in FIG. 65, rotation of the handheld surgicaluser interface 1406 about the pivot point 1430 results in a mirror-imagerotation of the end effector 528, e.g., rotation of the handheldsurgical user interface 1406 in a right direction, shown as arrow ‘A’results in rotation of the end effector 528 in an opposite, leftdirection, shown as arrow ‘B’. The relationship between the direction oftravel of the handheld surgical user interface 1406 and the end effector528 may be chosen to mimic the relationship between the handpiece of anon-robotic surgical device and an end effector, such as, for example,the surgical instruments shown in FIGS. 1-18.

FIG. 66 illustrates one embodiment of a wireless robotic surgicalcontrol system 1500 utilizing an optical interface between a wirelesshandheld surgical user interface 1506 and a wireless socket 1516. Thewireless socket 1516 may be configured to receive any suitable wirelesssignal from the wireless handheld surgical user interface 1506, such as,for example an optical signal (utilizing a laser in the visual ornon-visual spectrum), a radiofrequency signal, a microwave signal, or aninfrared signal. In one example embodiment, the wireless handheldsurgical user interface 1506 includes a wireless shaft 1524 fortransmitting a compatible wireless signal from the handheld surgicaluser interface 1506 to the wireless socket 1516. In one exampleembodiment, the signal transmitted to the socket 1516 may includesignals generated by one or more additional inputs located on or withinthe wireless surgical device handle 1522 of the wireless handheldsurgical user interface 1506, such as, for example, the shepherd's hooktrigger 1320, the first rotational knob 1326, or the second rotationalknob 1428. In another embodiment, the one or more additional inputs mayutilize a separate wireless signal, such as, for example, a wirelessBluetooth signal, to communicate with the controller 724.

In some embodiments, the wireless socket 1516 and the wireless shaft1524 may comprise a two-way communication system. In this embodiment,the wireless socket 1516 is capable of receiving signals from thewireless shaft 1524 and transmitting those signals to the controller 724located in the housing 1508. The wireless socket 1516 may also becapable of transmitting a signal from the controller 724 to the wirelesshandheld surgical user interface 1506 for controlling functions of thewireless handheld surgical user interface, such as, for example,providing control signals for one or more feedback devices 714 locatedwithin the wireless surgical device handle 1522. In another embodiment,a second wireless socket (not shown) may be located in the housing 1508to transmit signals from the controller 724 to the wireless handheldsurgical user interface 1506 for controlling the one or more feedbackdevices 174 located within the wireless surgical device handle 1522.

FIG. 67 shows one embodiment of the robotic surgical control system 1300interfaced with standard robotic surgical control system, such as, forexample, controller 518. As illustrated in FIG. 67, the robotic surgicalcontrol system 1300 may be connected to the controller 518 to provideadditional control functionality to controller 518. The controller 518,as described above, may provide an image of a working site through thedisplay 521. The controller 724 may interface with the controller 518through any suitable communication medium, such as, for example, a cableextending from the housing 1308. In the illustrated embodiment, thecontroller 518 further comprises one or more control knobs 1346 a,b,cfor controlling various functions of the handheld surgical userinterface 1506.

In one example embodiment, the one or more control knobs 1346 a,b,c maybe adjusted to control the ration between movement of the handheldsurgical user interface 1306 and the surgical instrument 522. Forexample, in one example embodiment, the first control knob 1346 a maycontrol the ration of movement between a longitudinal movement of thehandheld surgical user interface 1306 in a distal or proximal directionand a longitudinal movement of the surgical instrument 522. The secondcontrol knob 1346 b may be configured to control the ratio betweenmovement of the handheld surgical user interface 1306 about the pivotpoint 1330 in a left or right direction and lateral movement of thesurgical instrument 522 in a left or right direction. It will berecognized by those skilled in the art that the control knobs 1346a,b,c, may be configured to control the ratio of movement between anyportion of the robotic surgical control system 1300 and any portion ofthe robotic surgical system 500. In one example embodiment, the ratio ofmovement between the handheld surgical user interface 1306 and thesurgical instrument 522 may have a maximum ratio of 1:1 to movement. Inthis embodiment, a movement of the handheld surgical user interface of 1cm is converted into a corresponding movement of the surgical instrumentby 1 cm. In some embodiments, the ratio of movement may be adjusted suchthat the surgical instrument moves at a fractional value of the movementof the handheld surgical user interface. For example, in one exampleembodiment, the control knob 1346 a may be adjusted such that movementof the handheld surgical user interface in the distal direction of 1 cmresults in movement of the surgical instrument 522 in the distaldirection of 0.25 cm. Those skilled in the art will recognize that theseexamples are non-limiting, and that the ratio of movement between thehandheld surgical user interface 1306 and the surgical instrument 522may be a suitable ratio.

In one example embodiment, one or more sensitivity knobs may be locatedon the surgical device handle 1322 of the handheld surgical userinterface 1306. The one or more sensitivity knobs may be located on anyportion of the surgical device handle 1322. In one example embodiment,the a sensitivity knob may be located on the proximal-most part of thesurgical device handle 1322 to allow a user to easily adjust themovement ratio between the surgical device handle 1322 and the surgicalinstrument 522.

In one example embodiment, the one or more control knobs 1346 a,b,c maybe configured to control one or more functions of the display 521. Forexample, in one example embodiment, the third control knob 1346 c may berotated to adjust the view seen through the display 521. Adjustments tothe view may include, for example, changing the magnification of theview, changing the angle of the view, or changing the location beingviewed.

FIG. 68 illustrates one method for generating a feedback signal for theone or more feedback devices 714. The surgical instrument 1522 is asurgical instrument suitable for use with the robotic surgical system500, such as, for example, surgical instrument 522. In the illustratedembodiment, the surgical instrument 1522 is rotatable about alongitudinal axis of the shaft 1538. As the shaft 1538 is rotated aboutthe longitudinal axis, the end effector 1523 may come into contact witha tissue site 1530. The tissue site 1530 provides a resistive force tothe rotation of the shaft 1538. A feedback gear 1524 is located on theshaft 1538 and rotates in unison with the shaft 1538. The feedback gear1524 is operatively coupled to a resistive measurement device 1526. Theresistive measurement device 1526 is configured to measure the resistiveforce encountered by the end effector 1523 in contact with the tissuesite 1530 and generate a feedback signal which is transmitted to thecontroller 724 to control the one or more feedback devices 714. It willbe appreciated by those skilled in the art that FIG. 68 illustrates onlyone of the possible methods of generating a feedback signal for the oneor more feedback devices 714. The feedback signal may be generated byother suitable means, such as, for example, a potentiometer, a rheostat,a position sensor, a linear displacement sensor, a capacitive sensor, anelectrical resistance sensor, or any other suitable sensor forgenerating a feedback signal for the one or more feedback devices.

The control devices disclosed herein may be designed to be disposed ofafter a single use, or they can be designed to be used multiple timeswith one or more different types of end effectors. In either case,however, the devices can be reconditioned for reuse after at least oneuse. Reconditioning can include any combination of the steps ofdisassembly of the device, followed by cleaning or replacement ofparticular pieces, and subsequent reassembly. In particular, the devicescan be disassembled, and any number of the particular pieces or parts ofthe devices can be selectively replaced, added, or removed in anycombination. Those skilled in the art will appreciate that therecondition of the devices can utilize a variety of techniques fordisassembly, replacement, reprogramming, or reconfiguring. The use ofsuch techniques, and the resulting reconditioned device, are all withinthe scope of the present application.

Non-Limiting Examples

In one embodiment a robotic surgical system is provided. The roboticsurgical comprises a surgical robot comprising a surgical instrument,the surgical instrument comprising an end effector and a mechanicalinterface to manipulate the end effector. A control system comprising ahousing; a controller located in the housing coupled to a socket toreceive a handheld surgical user interface to control a function of thesurgical instrument, wherein the controller is operatively coupled tothe mechanical interface; at least one sensor coupled to the controllerand the socket, the at least one sensor to convert movement of thehandheld surgical user interface into electrical signals correspondingto the movement of the surgical instrument; and at least one feedbackdevice operably coupled to controller to provide feedback to the userthat is associated with a predetermined function of the surgicalinstrument.

In one embodiment method for controlling a robotic surgical device isprovided. The method comprises interfacing, via a socket, a controllerand a handheld surgical user interface; manipulating, by a user, thehandheld surgical user interface to produce one or more electricalsignals via a sensor operatively coupled to the handheld surgical userinterface and the controller; converting, via the controller, the one ormore electrical signals into one or more control signals for the roboticsurgical device; receiving, via the controller, one or more feedbacksignals from the robotic surgical device, and producing, via a feedbackdevice, one or more feedback conditions to emulate one or moreinteractions between the robotic surgical device and a tissue site.

Applicant also owns the following patent applications that are eachincorporated by reference in their respective entireties:

U.S. patent application Ser. No. 13/536,271, filed on Jun. 28, 2012 andentitled “Flexible Drive Member,” now U.S. Pat. No. 9,204,879;

U.S. patent application Ser. No. 13/536,288, filed on Jun. 28, 2012 andentitled “Multi-Functional Powered Surgical Device with ExternalDissection Features,” now U.S. Patent Application Publication No.2014/0005718;

U.S. patent application Ser. No. 13/536,295, filed on Jun. 28, 2012 andentitled “Rotary Actuatable Closure Arrangement for Surgical EndEffector,” now U.S. Pat. No. 9,119,657;

U.S. patent application Ser. No. 13/536,326, filed on Jun. 28, 2012 andentitled “Surgical End Effectors Having Angled Tissue-ContactingSurfaces,” now U.S. Pat. No. 9,289,256;

U.S. patent application Ser. No. 13/536,303, filed on Jun. 28, 2012 andentitled “Interchangeable End Effector Coupling Arrangement,” now U.S.Pat. No. 9,028,494;

U.S. patent application Ser. No. 13/536,393, filed on Jun. 28, 2012 andentitled “Surgical End Effector Jaw and Electrode Configurations,” nowU.S. Patent Application Publication No. 2014/0005640;

U.S. patent application Ser. No. 13/536,362, filed on Jun. 28, 2012 andentitled “Multi-Axis Articulating and Rotating Surgical Tools,” now U.S.Pat. No. 9,125,662; and

U.S. patent application Ser. No. 13/536,417, filed on Jun. 28, 2012 andentitled “Electrode Connections for Rotary Driven Surgical Tools,” nowU.S. Pat. No. 9,101,385.

It will be appreciated that the terms “proximal” and “distal” are usedthroughout the specification with reference to a clinician manipulatingone end of an instrument used to treat a patient. The term “proximal”refers to the portion of the instrument closest to the clinician and theterm “distal” refers to the portion located furthest from the clinician.It will further be appreciated that for conciseness and clarity, spatialterms such as “vertical,” “horizontal,” “up,” or “down” may be usedherein with respect to the illustrated embodiments. However, surgicalinstruments may be used in many orientations and positions, and theseterms are not intended to be limiting or absolute.

Various embodiments of surgical instruments and robotic surgical systemsare described herein. It will be understood by those skilled in the artthat the various embodiments described herein may be used with thedescribed surgical instruments and robotic surgical systems. Thedescriptions are provided for example only, and those skilled in the artwill understand that the disclosed embodiments are not limited to onlythe devices disclosed herein, but may be used with any compatiblesurgical instrument or robotic surgical system.

Reference throughout the specification to “various embodiments,” “someembodiments,” “one example embodiment,” or “an embodiment” means that aparticular feature, structure, or characteristic described in connectionwith the embodiment is included in at least one example embodiment.Thus, appearances of the phrases “in various embodiments,” “in someembodiments,” “in one example embodiment,” or “in an embodiment” inplaces throughout the specification are not necessarily all referring tothe same embodiment. Furthermore, the particular features, structures,or characteristics illustrated or described in connection with oneexample embodiment may be combined, in whole or in part, with features,structures, or characteristics of one or more other embodiments withoutlimitation.

While various embodiments herein have been illustrated by description ofseveral embodiments and while the illustrative embodiments have beendescribed in considerable detail, it is not the intention of theapplicant to restrict or in any way limit the scope of the appendedclaims to such detail. Additional advantages and modifications mayreadily appear to those skilled in the art. For example, it is generallyaccepted that endoscopic procedures are more common than laparoscopicprocedures. Accordingly, the present invention has been discussed interms of endoscopic procedures and apparatus. However, use herein ofterms such as “endoscopic”, should not be construed to limit the presentinvention to an instrument for use only in conjunction with anendoscopic tube (e.g., trocar). On the contrary, it is believed that thepresent invention may find use in any procedure where access is limitedto a small incision, including but not limited to laparoscopicprocedures, as well as open procedures.

It is to be understood that at least some of the figures anddescriptions herein have been simplified to illustrate elements that arerelevant for a clear understanding of the disclosure, while eliminating,for purposes of clarity, other elements. Those of ordinary skill in theart will recognize, however, that these and other elements may bedesirable. However, because such elements are well known in the art, andbecause they do not facilitate a better understanding of the disclosure,a discussion of such elements is not provided herein.

While several embodiments have been described, it should be apparent,however, that various modifications, alterations and adaptations tothose embodiments may occur to persons skilled in the art with theattainment of some or all of the advantages of the disclosure. Forexample, according to various embodiments, a single component may bereplaced by multiple components, and multiple components may be replacedby a single component, to perform a given function or functions. Thisapplication is therefore intended to cover all such modifications,alterations and adaptations without departing from the scope and spiritof the disclosure as defined by the appended claims.

Any patent, publication, or other disclosure material, in whole or inpart, that is said to be incorporated by reference herein isincorporated herein only to the extent that the incorporated materialsdoes not conflict with existing definitions, statements, or otherdisclosure material set forth in this disclosure. As such, and to theextent necessary, the disclosure as explicitly set forth hereinsupersedes any conflicting material incorporated herein by reference.Any material, or portion thereof, that is said to be incorporated byreference herein, but which conflicts with existing definitions,statements, or other disclosure material set forth herein will only beincorporated to the extent that no conflict arises between thatincorporated material and the existing disclosure material.

1-26. (canceled)
 27. A control system for a surgical robot, the controlsystem comprising: a controller; a sensor coupled to the controller; ahandheld surgical user interface coupled to the sensor and thecontroller; a feedback device coupled to the controller; and a firstsocket coupled to the controller, wherein the controller is configuredto couple to a stand-alone input device through the first socket. 28.The control system of claim 27, further comprising a surgical instrumentcompatibility logic configured to produce a signal indicative of thecompatibility of a surgical instrument with the handheld surgical userinterface.
 29. The control system of claim 27, wherein the sensorcomprises a six-degrees-of-freedom input device.
 30. The control systemof claim 29, wherein the sensor is configured to convert movement of thehandheld surgical user interface into electrical signals, wherein theelectrical signals correspond to movement of the surgical robot.
 31. Thecontrol system of claim 27, wherein the handheld surgical user interfaceis configured to provide control signals to the controller to control atleast one function of a surgical instrument connected to a roboticsurgical control system.
 32. The control system of claim 31, wherein theat least one function comprises at least one of delivering energy totissue, applying a force to the tissue, clamping the tissue, cutting thetissue, or manipulating a surgical instrument with respect to thetissue.
 33. The control system of claim 27, wherein the stand-aloneinput device comprises at least one feedback device.
 34. A controlsystem for a surgical robot, the control system comprising: acontroller; a sensor coupled to the controller; a handheld surgical userinterface coupled to the sensor and the controller; a feedback devicecoupled to the controller; and a first socket coupled to the controller,wherein the controller is configured to couple to a robotic surgicalsystem through a stand alone input device, and wherein the stand aloneinput device comprises a second socket to communicate with the firstsocket.
 35. The control system of claim 34, further comprising asurgical instrument compatibility logic configured to produce a signalindicative of the compatibility of a surgical instrument with thehandheld surgical user interface.
 36. The control system of claim 34,wherein the sensor comprises a six-degrees-of-freedom input device. 37.The control system of claim 36, wherein the sensor is configured toconvert movement of the handheld surgical user interface into electricalsignals, wherein the electrical signals correspond to movement of thesurgical robot.
 38. The control system of claim 34, wherein the handheldsurgical user interface is configured to provide control signals to thecontroller to control at least one function of a surgical instrumentconnected to the robotic surgical control system.
 39. The control systemof claim 38, wherein the at least one function comprises at least one ofdelivering energy to tissue, applying a force to the tissue, clampingthe tissue, cutting the tissue, or manipulating a surgical instrumentwith respect to the tissue.
 40. The control system of claim 34, whereinthe stand-alone input device comprises at least one feedback device.